Mateo Antuna, Daisy Coral

Mateo Antuna, Daisy Coral is an individual health care provider with primary practice located at 4041 N Central Ave Bldg C , Phoenix AZ 85012-3313. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Mateo Antuna, Daisy Coral can be contacted via phone (602) 279-5351.

Contact Information

Primary practice address
4041 N Central Ave Bldg C Phoenix AZ 85012-3313
Phone: (602) 279-5351
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Counselor 101Y00000X D10847152 Arizona

Profile Details

NPI number 1518333699
LBN Legal business name Mateo Antuna, Daisy Coral
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2015
Last updated Feb 10th, 2021 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1518333699 NPPES
Massachusetts MEDICAID 1307576
Massachusetts Other M18463
Massachusetts MEDICAID 1303295

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