Individual
MARY KOEHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1715 W DESPERADO WAY, PHOENIX, AZ 85085-6329
(602) 292-2872
Mailing address
1715 W DESPERADO WAY, PHOENIX, AZ 85085-6329
(602) 292-2872
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW-11595
AZ
Other
Enumeration date
03/26/2007
Last updated
03/27/2014
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