Organization
V3 OUTREACH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON G. WILSON (PRESIDENT)
(520) 289-4480
Entity
Organization
Contact information
Practice address
1308 N VENICE AVE, TUCSON, AZ 85712-3936
(520) 325-9841
Mailing address
1309 N VENICE AVE, TUCSON, AZ 85712-3935
(520) 325-9841
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
102L00000X
Psychoanalyst
—
—
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
103TR0400X
Rehabilitation Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
03/02/2009
Last updated
03/02/2009
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