Provider Demographics
NPI:1912212499
Name:GANZ, HILLARY NICOLE
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:NICOLE
Last Name:GANZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14358 N FRANK LLOYD WRIGHT BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-8845
Mailing Address - Country:US
Mailing Address - Phone:602-910-0538
Mailing Address - Fax:480-477-5794
Practice Address - Street 1:14358 N FRANK LLOYD WRIGHT BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-8845
Practice Address - Country:US
Practice Address - Phone:602-910-0538
Practice Address - Fax:480-477-5794
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13066101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health