Individual provider · Type 1 NPI

Edward Omar Ontiveros, LAC

Mental Health Counselor · Tempe, AZ

NPI number 1457074098 Active

Practice location

4801 S Lakeshore Dr Ste 106
Tempe, AZ 85282-7156

Mailing address

3924 E Minton St
Phoenix, AZ 85042-6229

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XLAC-21115 (AZ)

Mental Health Counselor: Definition to come...

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About NPI 1457074098

Edward Omar Ontiveros, LAC's National Provider Identifier is 1457074098, issued on Sep 20, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Tempe, AZ. The record was last updated on Sep 20, 2022.