Provider Demographics
NPI:1548868615
Name:DRAWERT, PATRICIA ANN (LISAC, LAC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:DRAWERT
Suffix:
Gender:F
Credentials:LISAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 E UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-7004
Mailing Address - Country:US
Mailing Address - Phone:480-625-8159
Mailing Address - Fax:480-324-2463
Practice Address - Street 1:4330 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-7004
Practice Address - Country:US
Practice Address - Phone:480-218-3280
Practice Address - Fax:480-324-2463
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-11425101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)