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Individual

NORMAN E MUDD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, LMFT

Contact information

Practice address
210 E COTTONWOOD LN, CASA GRANDE, AZ 85222-2514
(520) 836-1688
(520) 421-2708
Mailing address
PO BOX 6188, CHANDLER, AZ 85246-6188

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT-0068
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
752536
AZ
01
LMFT0068
LICENSE
AZ
Enumeration date
09/28/2006
Last updated
07/09/2007
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