Individual
NEDA TAVASSOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3033 N CENTRAL AVE STE 700, PHOENIX, AZ 85012-2806
(602) 230-7373
(602) 257-8029
Mailing address
3620 N 3RD ST, PHOENIX, AZ 85012-2020
(602) 230-7373
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LAC17923
AZ
101YP2500X
Professional Counselor
Primary
19985
AZ
Other
Enumeration date
04/08/2019
Last updated
07/19/2021
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