Individual
AUTUMN RE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3347 N WINDSONG DR FL 2, PRESCOTT VALLEY, AZ 86314-2283
(928) 445-5211
Mailing address
3347 N WINDSONG DR FL 2, PRESCOTT VALLEY, AZ 86314-2283
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-22984
AZ
Other
Enumeration date
06/04/2026
Last updated
06/04/2026
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