Individual
JONATHAN RYAN GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MC, LPC
Contact information
Practice address
7254 E SOUTHERN AVE STE 106, MESA, AZ 85209-2787
(505) 270-6677
Mailing address
7254 E SOUTHERN AVE STE 106, MESA, AZ 85209-2787
(505) 270-6677
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-21545
AZ
Other
Enumeration date
12/08/2022
Last updated
12/08/2022
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