Individual
MARTHA L DE LA TORRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
201 S 64TH AVE, PHOENIX, AZ 85043-3406
(308) 207-5148
Mailing address
201 S 64TH AVE, PHOENIX, AZ 85043-3406
(623) 336-2840
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
19574
AZ
101YP2500X
Professional Counselor
Primary
3315
KS
Other
Enumeration date
05/27/2021
Last updated
11/18/2024
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