Individual
DWAYNE PAUL DE LA PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
400 N 32ND ST, PHOENIX, AZ 85008-6205
(602) 914-2900
Mailing address
400 N 32ND ST, PHOENIX, AZ 85008-6205
(602) 914-2900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LMSW-21250
AZ
Other
Enumeration date
11/16/2023
Last updated
11/16/2023
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