Provider Demographics
NPI:1588870612
Name:PIEDRA, ANN ELIZABETH (LPC)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:ELIZABETH
Last Name:PIEDRA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:ELIZABETH
Other - Last Name:PIEDRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MC
Mailing Address - Street 1:1326 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-6213
Mailing Address - Country:US
Mailing Address - Phone:480-966-9934
Mailing Address - Fax:480-968-3165
Practice Address - Street 1:HOLDEMAN ELEMENTARY SCHOOL
Practice Address - Street 2:1326 W 18TH STREET
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-6213
Practice Address - Country:US
Practice Address - Phone:480-966-9934
Practice Address - Fax:480-968-3165
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health