Individual
MR. ALAN KOVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LASAC
Contact information
Practice address
5017 N 62ND AVE, GLENDALE, AZ 85301-7317
(602) 477-9562
Mailing address
5017 N 62ND AVE, GLENDALE, AZ 85301-7317
(602) 477-9562
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LASAC-13281
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045584
—
AZ
Enumeration date
07/27/2016
Last updated
07/27/2016
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