Individual
KELSEY CODY SKOWRONSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
5320 N 16TH ST STE 110, PHOENIX, AZ 85016-3241
(602) 456-2835
Mailing address
3963 W CAMINO DEL RIO, GLENDALE, AZ 85310-5526
(928) 219-0865
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC-22065
AZ
Other
Enumeration date
08/21/2024
Last updated
08/28/2024
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