Individual
DR. CAROL ANN GEGENHEIMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., LISAC, LMFT
Contact information
Practice address
17100 N 67TH AVENUE, SUITE 400, GLENDALE, AZ 85308-3698
(602) 938-3323
(602) 938-1626
Mailing address
17100 N 67TH AVENUE, SUITE 400, GLENDALE, AZ 85308-3698
(602) 938-3323
(602) 938-1626
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-10198
AZ
106H00000X
Marriage & Family Therapist
Primary
LMFT-10101
AZ
Other
Enumeration date
10/26/2006
Last updated
07/16/2013
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