Individual
JULIE LIFESTYLE PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
810 S ALMA SCHOOL RD STE 4, MESA, AZ 85210-1091
(480) 699-9299
Mailing address
810 S ALMA SCHOOL RD STE 4, MESA, AZ 85210-1091
(480) 699-9299
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSLG12053
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
883852528
—
AZ
Enumeration date
11/22/2022
Last updated
11/22/2022
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