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Individual

MELODY LEE BRIMHALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MAPC,LPC,LISAC,NCC

Contact information

Practice address
207 N GILBERT RD STE 107, GILBERT, AZ 85234-5814
(480) 980-0059
Mailing address
1759 E FOUNTAIN ST, MESA, AZ 85203-5121
(480) 980-0059

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-11873
AZ
101YP2500X
Professional Counselor
Primary
LPC-13383
AZ

Other

Enumeration date
02/02/2010
Last updated
02/04/2010
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