Individual
ALFHONSO TRACEY HAVATONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW-11476
Contact information
Practice address
10005 E OSBORN RD, SCOTTSDALE, AZ 85256-4019
(480) 362-5505
(480) 362-7586
Mailing address
11445 N 39TH LN, PHOENIX, AZ 85029-3003
(602) 434-5246
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW-11476
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
860143787
EMPLOYER
AZ
Enumeration date
10/15/2012
Last updated
10/15/2012
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