Provider Demographics
NPI:1871031740
Name:HUERTA, ROSARIO (LPC)
Entity Type:Individual
Prefix:
First Name:ROSARIO
Middle Name:
Last Name:HUERTA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6675 S SQUAWROOT PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85756-5103
Mailing Address - Country:US
Mailing Address - Phone:520-528-1065
Mailing Address - Fax:
Practice Address - Street 1:994 S HARRISON RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85748-6608
Practice Address - Country:US
Practice Address - Phone:520-721-1887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC16526101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional