Provider Demographics
NPI:1245304146
Name:TWOREK, GRAZIA
Entity type:Individual
Prefix:MS
First Name:GRAZIA
Middle Name:
Last Name:TWOREK
Suffix:
Gender:F
Credentials:
Other - Prefix:MR
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:TWOREK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6985 E CARRIAGE TRAILS DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85266-6591
Mailing Address - Country:US
Mailing Address - Phone:480-628-9097
Mailing Address - Fax:
Practice Address - Street 1:6985 E CARRIAGE TRAILS DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85266-6591
Practice Address - Country:US
Practice Address - Phone:480-628-9097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8900385HR2055X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ905888OtherAHCCCS ID NUMBER