Organization
FAMILY TREE THERAPY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALISA JIMENEZ LPC (OWNER)
(954) 253-8559
Entity
Organization
Contact information
Practice address
4425 E AGAVE RD STE 106, PHOENIX, AZ 85044-0620
(480) 248-5338
Mailing address
4425 E AGAVE RD STE 106, PHOENIX, AZ 85044-0620
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
02/21/2019
Last updated
11/01/2019
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