Individual
MR. MAXWELL EARL REED STOLTENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4718 N 3RD AVE, PHOENIX, AZ 85013-2705
(928) 853-7109
Mailing address
4718 N 3RD AVE, PHOENIX, AZ 85013-2705
(928) 853-7109
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-17355
AZ
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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