Provider Demographics
NPI:1306289277
Name:ARAMBURO, ASA RACQUEL (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ASA
Middle Name:RACQUEL
Last Name:ARAMBURO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ASA
Other - Middle Name:RACQUEL
Other - Last Name:GEMIGNANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6717 N OCOTILLO HERMOSA CIR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-1017
Mailing Address - Country:US
Mailing Address - Phone:602-652-2613
Mailing Address - Fax:602-223-1235
Practice Address - Street 1:6717 N OCOTILLO HERMOSA CIR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-1017
Practice Address - Country:US
Practice Address - Phone:602-652-2613
Practice Address - Fax:602-223-1235
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL55471041C0700X
AZ174011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty