Individual
BRIANDA I. TETERUKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
21436 N 20TH AVE, PHOENIX, AZ 85027-2612
(602) 888-1107
Mailing address
21681 N 61ST AVE, GLENDALE, AZ 85308-6316
(520) 313-0608
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-20112
AZ
Other
Enumeration date
09/24/2021
Last updated
09/24/2021
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