Individual
DARIAN GANNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CPRP
Contact information
Practice address
40 E MITCHELL DR, SUITE 200, PHOENIX, AZ 85012-2330
(602) 995-7474
(602) 254-5666
Mailing address
PO BOX 50927, MESA, AZ 85207
(602) 995-7474
(602) 254-5666
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-10366
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCSW - 10366
SOCIAL WORK LICENSE
AZ
Enumeration date
01/31/2007
Last updated
07/08/2007
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