Individual
KATHERINE MARIE HANLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17235 N 75TH AVE STE F100, GLENDALE, AZ 85308-0871
(480) 641-1165
Mailing address
12081 WEST LISBON LN, EL MIRAGE, AZ 85335
(314) 477-5105
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/04/2021
Last updated
08/04/2021
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