Individual
AUTUMN R LORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1668 E KELSI AVE, SAN TAN VALLEY, AZ 85140-4085
(480) 616-5133
Mailing address
1668 E KELSI AVE, SAN TAN VALLEY, AZ 85140-4085
(480) 616-5133
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
04/20/2022
Last updated
04/20/2022
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