Individual
BILLIE CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22444 W MADRE DEL ORO DR, WITTMANN, AZ 85361-8656
(602) 326-4801
Mailing address
22444 W MADRE DEL ORO DR, WITTMANN, AZ 85361-8656
(602) 326-4801
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-1668
AZ
Other
Enumeration date
02/19/2017
Last updated
02/19/2017
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