Organization
AZPEN COUNSELING & SERVICES, LLC
Active
Other names
Molly Port
Organization subpart
No
Provider details
NPI number
Authorized official
MOLLY PORT LPC, NCC (OWNER/LICENSED PROFESSIONAL COUNSEL)
(928) 855-4900
Entity
Organization
Contact information
Practice address
1930 MESQUITE AVE, #1A, LAKE HAVASU CITY, AZ 86403
(928) 855-4900
(928) 855-4902
Mailing address
1930 MESQUITE AVE, #1A, LAKE HAVASU CITY, AZ 86403
(928) 855-4900
(928) 855-4902
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
16468
AZ
Other
Enumeration date
02/14/2017
Last updated
04/27/2019
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