Provider Demographics
NPI:1245931930
Name:CALLINI, MANUELA
Entity type:Individual
Prefix:MRS
First Name:MANUELA
Middle Name:
Last Name:CALLINI
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 1:1518 W ORANGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-7950
Mailing Address - Country:US
Mailing Address - Phone:623-297-5153
Mailing Address - Fax:
Practice Address - Street 1:8825 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-0008
Practice Address - Country:US
Practice Address - Phone:602-341-6150
Practice Address - Fax:602-675-4070
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11474171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator