Provider Demographics
NPI:1285036483
Name:EASTON, APHRODITE
Entity type:Individual
Prefix:
First Name:APHRODITE
Middle Name:
Last Name:EASTON
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 1:9905 E TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-6476
Mailing Address - Country:US
Mailing Address - Phone:602-693-2739
Mailing Address - Fax:
Practice Address - Street 1:9905 E TEXAS AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-6476
Practice Address - Country:US
Practice Address - Phone:602-693-2739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-18
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA222327OtherASSOCIATION OF SOCIAL WORK BOARDS