Organization
WELLIFE COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA G VACCARO MSW LCSW (OWNER)
(928) 636-7890
Entity
Organization
Contact information
Practice address
1968 US HIGHWAY 89 SOUTH, CHINO VALLEY, AZ 86323
(928) 636-7890
Mailing address
PO BOX 2863, CHINO VALLEY, AZ 86323-2703
(928) 636-7890
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCSW10904
AZ
Other
Enumeration date
08/24/2007
Last updated
04/20/2008
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