Fusillo, Tara
Fusillo, Tara is an individual health care provider with primary practice located at 3050 W Agua Fria Fwy Ste 150 , Phoenix AZ 85027-3998. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Fusillo, Tara can be contacted via phone (928) 713-1619.Contact Information
Primary practice address
3050 W Agua Fria Fwy Ste 150
Phoenix AZ 85027-3998
Phone: (928) 713-1619
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 15247 | Arizona |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | LASAC-15247 |
Profile Details
| NPI number | 1356113179 |
|---|---|
| LBN Legal business name | Fusillo, Tara |
| Credentials | LASAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 25th, 2023 |
| Last updated | Oct 25th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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