Organization
GOTHAM RANCH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA LYNN BREZNAK-HIGGINS LPC (OWNER/COUNSELOR)
(480) 577-5327
Entity
Organization
Contact information
Practice address
4342 E EDGEWOOD AVE, MESA, AZ 85206-2646
(480) 577-5327
Mailing address
4342 E EDGEWOOD AVE, MESA, AZ 85206-2646
(480) 577-5327
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
07/27/2018
Last updated
12/02/2023
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