Organization
DALLACQUA PSYCHOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN DALLACQUA PSY.D. (MANAGER)
(928) 432-5358
Entity
Organization
Contact information
Practice address
3157 S HANNAH LN, FLAGSTAFF, AZ 86005-6409
(928) 362-2622
Mailing address
3157 S HANNAH LN, FLAGSTAFF, AZ 86005-6409
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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