Organization
TIDES OF CHANGE CENTER OF WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIANNE S VALLADARES LCSW (PRESIDENT)
(520) 249-7650
Entity
Organization
Contact information
Practice address
1451 E REDROCK DR, SIERRA VISTA, AZ 85650-8499
(520) 249-7650
Mailing address
1451 E REDROCK DR, SIERRA VISTA, AZ 85650-8499
(520) 249-7650
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCSW10948
AZ
Other
Enumeration date
04/15/2010
Last updated
04/15/2010
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