Individual
ANGELA BASSETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8 E COTTONWOOD ST, COTTONWOOD, AZ 86326-4382
(877) 634-7333
(928) 634-8960
Mailing address
8 E COTTONWOOD ST, COTTONWOOD, AZ 86326-4382
(877) 634-7333
(928) 634-8960
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC15212
AZ
Other
Enumeration date
04/29/2021
Last updated
04/29/2021
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