Individual
DAVONA D BLACKHORSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
2204 S DOBSON RD STE 201, MESA, AZ 85202-6457
(602) 230-7373
Mailing address
3101 N CENTRAL AVE STE 500, PHOENIX, AZ 85012-2639
(602) 230-7373
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-20688
AZ
Other
Enumeration date
09/15/2023
Last updated
09/15/2023
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