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Organization

OCOTILLO COUNSELING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GISEL TREVINO-MARTINEZ LCSW (OWNER)
(480) 930-0390
Entity
Organization

Contact information

Practice address
1300 E MISSOURI AVE STE 120, PHOENIX, AZ 85014-2372
(480) 930-0390
Mailing address
1300 E MISSOURI AVE STE 120, PHOENIX, AZ 85014-2372
(480) 930-0390

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1942840103
COMMERCIAL
AZ
Enumeration date
11/10/2020
Last updated
01/19/2023
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