Basic Information
Provider Information
NPI: 1225328255
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MROZOWSKI
FirstName: RAQUEL
MiddleName: MARIE
NamePrefix: MRS.
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3170 E FORT LOWELL RD
Address2:  
City: TUCSON
State: AZ
PostalCode: 857161615
CountryCode: US
TelephoneNumber: 5207954977
FaxNumber: 5207954981
Practice Location
Address1: 7750 E BROADWAY BLVD STE A100
Address2:  
City: TUCSON
State: AZ
PostalCode: 857103901
CountryCode: US
TelephoneNumber: 5203271529
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/11/2011
LastUpdateDate: 06/23/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/23/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000XLMSW-12241AZY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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