Individual
BERNADETTE MARISCAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LAC, NCC
Contact information
Practice address
5418 E SKYLINE DR, BUILDING 1, SAN TAN VALLEY, AZ 85140-9000
(602) 326-5379
Mailing address
270 E HUNT HWY, SUITE 16, PBM # 144, SAN TAN VALLEY, AZ 85143-4962
(602) 326-5379
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-13757
AZ
Other
Enumeration date
06/14/2012
Last updated
06/14/2012
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