Individual
KATHERINE CHERYL NISBET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LASAC
Contact information
Practice address
3301 E PINCHOT AVE, PHOENIX, AZ 85018-6807
(602) 599-5525
(602) 956-3636
Mailing address
202 E EARLL DR, SUITE 200, PHOENIX, AZ 85012-2647
(602) 599-5404
(602) 599-5704
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/18/2014
Last updated
11/18/2014
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