Individual
ALYSSA L FAGAN-CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
20440 N 27TH AVE, PHOENIX, AZ 85027-3240
(480) 882-4545
(602) 910-2949
Mailing address
7500 N DREAMY DRAW DR STE 145, PHOENIX, AZ 85020-4668
(480) 886-2454
(602) 409-0499
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-21945
AZ
Other
Enumeration date
08/15/2013
Last updated
12/27/2023
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