Individual
MRS. LEA BASTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAAC
Contact information
Practice address
36075 S RINCON RD, WICKENBURG, AZ 85390-2491
(928) 418-2072
(928) 684-9592
Mailing address
27215 N 230TH AVE, WITTMANN, AZ 85361-5811
(602) 799-5985
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAAC-15394
AZ
Other
Enumeration date
04/04/2025
Last updated
04/04/2025
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