Individual
MRS. WINNIFRED ELLEN MENDIVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.E.D., L.I.S.A.C.
Contact information
Practice address
10005 E. OSBORN ROAD, SCOTTSDALE, AZ 85256-4019
(480) 362-5615
Mailing address
10129 W ILLINI ST, TOLLESON, AZ 85353-4110
(623) 594-8522
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-10913
AZ
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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