Provider Demographics
NPI:1992342281
Name:UNIVERSITY OF ARIZONA
Entity type:Organization
Organization Name:UNIVERSITY OF ARIZONA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXTENSION SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:R
Authorized Official - Last Name:INFANTE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, RD
Authorized Official - Phone:520-621-1584
Mailing Address - Street 1:4210 N CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-1109
Mailing Address - Country:US
Mailing Address - Phone:404-333-3737
Mailing Address - Fax:
Practice Address - Street 1:4210 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-1109
Practice Address - Country:US
Practice Address - Phone:520-621-1584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health