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Individual

IVAN ATOLE III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
302 W PONDEROSA ST,, WHITERIVER, AZ 85941
(928) 338-4858
Mailing address
PO BOX 1790, WHITERIVER, AZ 85941-1790

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC.0017086
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
VJ546645
OH
Enumeration date
03/13/2019
Last updated
02/06/2023
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