Provider Demographics
NPI:1750151239
Name:MAGDA, CLAUDIA ADRIANA
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:ADRIANA
Last Name:MAGDA
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 1:2880 W CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-7041
Mailing Address - Country:US
Mailing Address - Phone:602-491-6232
Mailing Address - Fax:
Practice Address - Street 1:3192 N WINDSONG DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-2239
Practice Address - Country:US
Practice Address - Phone:928-288-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-21919225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist