Provider Demographics
NPI:1730970054
Name:CRAIG, TRUDY M (LAAC)
Entity type:Individual
Prefix:
First Name:TRUDY
Middle Name:M
Last Name:CRAIG
Suffix:
Gender:F
Credentials:LAAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-2215
Mailing Address - Country:US
Mailing Address - Phone:602-642-5497
Mailing Address - Fax:
Practice Address - Street 1:645 W ASH RIDGE DR
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-5493
Practice Address - Country:US
Practice Address - Phone:520-440-5129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15436101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional