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Individual

MRS. KIRAN - GUPTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW -2678

Contact information

Practice address
1405 N DOBSON RD, SUITE 1, CHANDLER, AZ 85224-8594
(480) 213-6502
(480) 726-0197
Mailing address
2743 W IRONWOOD DR, CHANDLER, AZ 85224-3915
(480) 917-4586

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-2678
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11451151
CAQH DATA SUMMARY
AZ
Enumeration date
04/10/2007
Last updated
07/08/2007
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