Individual
KAITLIN LARISSA ABRAVAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
3635 E INVERNESS AVE STE 109, MESA, AZ 85206-3848
(480) 645-1610
Mailing address
11024 E DIAMOND AVE, MESA, AZ 85208-7647
(480) 645-1610
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC18255
AZ
Other
Enumeration date
01/15/2020
Last updated
05/20/2021
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