Individual
MICHELLE RUTH MACILVAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4530 E RAY RD STE 120, PHOENIX, AZ 85044-6095
(480) 637-5574
Mailing address
64 S LAVEEN PL, CHANDLER, AZ 85226-5049
(602) 509-5882
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC-14057
AZ
101YP2500X
Professional Counselor
Primary
LPC-14057
AZ
Other
Enumeration date
01/28/2013
Last updated
03/14/2024
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