Individual
MARIA J BIRDSALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAC
Contact information
Practice address
4864 E BASELINE RD STE 106, MESA, AZ 85206-4629
(480) 999-0458
Mailing address
884 S ADAM WAY, GILBERT, AZ 85296-1486
(956) 223-0726
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-20630
AZ
Other
Enumeration date
07/31/2023
Last updated
07/31/2023
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