Individual
MARIA CASAL PORTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
13395 N MARANA MAIN ST BLDG B, MARANA, AZ 85653-7008
(520) 682-1091
(520) 682-4132
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-1091
(520) 682-4132
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LAC18044
AZ
101YP2500X
Professional Counselor
Primary
LPC-21456
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147462
—
AZ
05
—
572555
—
AZ
Enumeration date
09/08/2020
Last updated
01/04/2023
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