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Individual

MR. DUANE GAGNON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, EDS

Contact information

Practice address
2400 W QUAIL SPRINGS RANCH RD, COTTONWOOD, AZ 86326-2892
(928) 301-7098
Mailing address
2400 W QUAIL SPRINGS RANCH RD, COTTONWOOD, AZ 86326-2892

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
687957
AZ
Enumeration date
05/29/2007
Last updated
07/26/2007
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