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Individual

STACI JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAC

Contact information

Practice address
2314 S VAL VISTA DR STE 101, GILBERT, AZ 85295-5591
(480) 804-0326
(480) 804-0083
Mailing address
1400 E SOUTHERN AVE STE 735, TEMPE, AZ 85282-5699
(480) 804-0326
(480) 804-0083

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-22673
AZ

Other

Enumeration date
02/16/2024
Last updated
02/16/2024
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