Provider Demographics
NPI:1750931317
Name:RIZWI, NUTAILA (LPC)
Entity type:Individual
Prefix:
First Name:NUTAILA
Middle Name:
Last Name:RIZWI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:NUTAILA
Other - Middle Name:
Other - Last Name:AZIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3003 N CENTRAL AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2929
Mailing Address - Country:US
Mailing Address - Phone:602-685-6000
Mailing Address - Fax:602-302-7925
Practice Address - Street 1:1642 S. PRIEST DRIVE
Practice Address - Street 2:BLDG. 6, STE. 101
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281
Practice Address - Country:US
Practice Address - Phone:602-685-6000
Practice Address - Fax:480-731-1066
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2024-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22896101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional