Individual
DEANNA D. VANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, LPC
Contact information
Practice address
222 E BIRCH AVE, FLAGSTAFF, AZ 86001
(928) 607-9749
Mailing address
120 W COTTAGE AVE, FLAGSTAFF, AZ 86001
(928) 607-9749
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-10224
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
728206
AHCCCS PROVIDER #
AZ
01
—
LPC-10224
LPC
AZ
Enumeration date
10/10/2006
Last updated
05/11/2022
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