Individual
MR. RICHARD GAVIN WRIGHT LAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1892
(602) 877-2876
Mailing address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1892
(602) 877-2876
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
18398
AZ
Other
Enumeration date
07/22/2020
Last updated
07/22/2020
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