Individual
MICHAEL WHITWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
13260 N 94TH DR STE 100, PEORIA, AZ 85381-4242
(623) 487-7763
(623) 486-8276
Mailing address
13260 N 94TH DR STE 100, PEORIA, AZ 85381-4242
(623) 487-7763
(623) 486-8276
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
19499
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19499
LICENSE
AZ
Enumeration date
04/09/2024
Last updated
04/09/2024
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