Individual
MARY KRISTENE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1836 N STAPLEY DR UNIT 77, MESA, AZ 85203-2675
(480) 586-1429
Mailing address
1836 N STAPLEY DR UNIT 77, MESA, AZ 85203-2675
(480) 586-1429
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-15202
AZ
101YM0800X
Mental Health Counselor
Primary
LPC-19373
AZ
Other
Enumeration date
05/11/2018
Last updated
01/25/2022
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