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Individual

DA'MOND O GADSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
2202 W MCDOWELL RD, PHOENIX, AZ 85009-3009
(602) 518-0214
Mailing address
7214 W READE AVE, GLENDALE, AZ 85303-6124
(602) 518-0214

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-15178
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
008085
AHCCCS
AZ
05
935106
AZ
Enumeration date
06/25/2013
Last updated
07/21/2020
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