Individual
VANESSA VIDALES QUINTANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3826 W BERYL AVE, PHOENIX, AZ 85051-1138
(760) 212-9128
Mailing address
3826 W BERYL AVE, PHOENIX, AZ 85051-1138
(760) 212-9128
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMFT15910
AZ
Other
Enumeration date
04/17/2014
Last updated
02/10/2025
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