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Individual

MR. MARTY W. BAHE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
A.A.

Contact information

Practice address
1 MILE NORTH ON HIGHWAY 163, KAYENTA, AZ 86033-0487
(928) 697-5570
(928) 697-5574
Mailing address
PO BOX 487, 1 MILE NORTH ON HIGHWAY 163, KAYENTA, AZ 86033-0487
(928) 697-5570
(928) 697-5574

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC - 11443
AZ

Other

Enumeration date
01/10/2012
Last updated
01/10/2012
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