Individual
NICOLE DEGLANE CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
250 N LITCHFIELD RD STE 201, GOODYEAR, AZ 85338-1372
(623) 337-2275
Mailing address
17362 W PATRICK LN, SURPRISE, AZ 85387-4129
(602) 820-9912
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC08037T
AZ
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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