Individual
SEOL KI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
747 N SPARROW DR, GILBERT, AZ 85234-7488
(480) 630-8678
Mailing address
747 N SPARROW DR, GILBERT, AZ 85234-7488
(480) 259-0305
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LMSW-19966
AZ
Other
Enumeration date
12/13/2021
Last updated
12/23/2025
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