Individual
CONLEY M LAROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LASAC
Contact information
Practice address
617 N SCOTTSDALE RD STE D, SCOTTSDALE, AZ 85257-4207
(480) 955-0864
Mailing address
1800 W ELLIOT RD UNIT 140, CHANDLER, AZ 85224-8823
(602) 327-9008
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LASAC-7070T
AZ
Other
Enumeration date
02/23/2022
Last updated
02/23/2022
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