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Individual

MARI OXENTENKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1840 N 95TH AVE STE 160, PHOENIX, AZ 85037-4313
(623) 234-9811
(623) 234-9815
Mailing address
4747 N 7TH ST STE 100, PHOENIX, AZ 85014-3654

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-17749
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
468914
AZ
Enumeration date
12/20/2018
Last updated
08/10/2022
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