Individual
PRESTON ANDREW SLADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20860 E. TATUM BLVD STE, 300, PHOENIX, AZ 85050
(866) 342-8847
Mailing address
1245 E HALIFAX ST, MESA, AZ 85203-3821
(480) 625-2808
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
RBT-18-59786
AZ
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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