Provider Demographics
NPI:1972097111
Name:FRANCIS, UVOLTTA (LPC-22105)
Entity Type:Individual
Prefix:
First Name:UVOLTTA
Middle Name:
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:LPC-22105
Other - Prefix:
Other - First Name:UVOLTTA
Other - Middle Name:
Other - Last Name:GARDNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC-22105
Mailing Address - Street 1:2548 E AUGUSTA AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-0199
Mailing Address - Country:US
Mailing Address - Phone:623-215-5138
Mailing Address - Fax:
Practice Address - Street 1:2548 E AUGUSTA AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85298-0199
Practice Address - Country:US
Practice Address - Phone:623-215-5138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 322D00000X, 106S00000X
AZLAC-16940101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician