Organization
REKINDLE YOUR SOUL, PLLC
Active
Organization
REKINDLE YOUR SOUL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH GRACA PHD (OWNER)
(520) 249-0352
Entity
Organization
Contact information
Practice address
315 BARTOW DR, SIERRA VISTA, AZ 85635-1805
(520) 249-0352
(855) 568-6439
Mailing address
PO BOX 1667, BISBEE, AZ 85603-2667
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
AZ
Other
Enumeration date
05/05/2014
Last updated
05/05/2014
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