Provider Demographics
NPI:1497481170
Name:MAZA, NAOMI
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:MAZA
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 1:10105 E VIA LINDA STE 103-7
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5311
Mailing Address - Country:US
Mailing Address - Phone:480-679-8743
Mailing Address - Fax:
Practice Address - Street 1:10105 E VIA LINDA STE 103-7
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5311
Practice Address - Country:US
Practice Address - Phone:480-679-8743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-20640104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker