Individual
RICK E. POULIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISAC
Contact information
Practice address
483 W. SEED FARM RD., NEW BEGINNINGS BUILDING, SACATON, AZ 85247-0038
(602) 528-7164
(602) 528-1374
Mailing address
483 W. SEED FARM RD., NEW BEGINNINGS BUILDING, SACATON, AZ 85247-0038
(602) 528-7164
(602) 528-1374
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-10549
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
346214
—
AZ
Enumeration date
02/05/2008
Last updated
02/05/2008
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