Provider Demographics
NPI:1881230936
Name:KNADJIAN, EVE (LAC)
Entity Type:Individual
Prefix:
First Name:EVE
Middle Name:
Last Name:KNADJIAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4110 E LUDLOW DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-5825
Mailing Address - Country:US
Mailing Address - Phone:480-620-5852
Mailing Address - Fax:
Practice Address - Street 1:8414 E SHEA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6665
Practice Address - Country:US
Practice Address - Phone:480-235-1682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-16200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health