Individual
AMALA JOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4001 E BASELINE RD STE 204, GILBERT, AZ 85234-2743
(480) 269-2971
(480) 452-0691
Mailing address
70 S VAL VISTA DR STE A3-659, GILBERT, AZ 85296-1374
(480) 269-2971
(480) 452-0691
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
21311
AZ
Other
Enumeration date
04/19/2023
Last updated
04/19/2023
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