Provider Demographics
NPI:1184239188
Name:GUZMAN, VERONICA (LPC, TIYT, CCTSS)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:LPC, TIYT, CCTSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 E TULSA ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-8246
Mailing Address - Country:US
Mailing Address - Phone:602-502-8120
Mailing Address - Fax:
Practice Address - Street 1:1910 E TULSA ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-8246
Practice Address - Country:US
Practice Address - Phone:602-502-8120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-16638101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty