Individual
ANDREA EMERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
18488 W IDA LN, SURPRISE, AZ 85387-1515
(602) 633-5712
Mailing address
18488 W IDA LN, SURPRISE, AZ 85387-1515
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-20637
AZ
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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