Provider Demographics
NPI:1356425748
Name:HARTZLER, MARY CHRISTINE (MA, LPC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CHRISTINE
Last Name:HARTZLER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 W 8TH ST
Mailing Address - Street 2:PO BOX 446
Mailing Address - City:SAFFORD
Mailing Address - State:AZ
Mailing Address - Zip Code:85546-2807
Mailing Address - Country:US
Mailing Address - Phone:928-428-6554
Mailing Address - Fax:
Practice Address - Street 1:624 W 8TH ST
Practice Address - Street 2:
Practice Address - City:SAFFORD
Practice Address - State:AZ
Practice Address - Zip Code:85546-2807
Practice Address - Country:US
Practice Address - Phone:928-428-6554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-1564101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional