Individual
MARISSA SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
5550 N 16TH ST APT 122, PHOENIX, AZ 85016-2942
(623) 687-0936
Mailing address
3104 E CAMELBACK RD UNIT 7711, PHOENIX, AZ 85016-4502
(480) 271-1788
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LMSW-19201
AZ
1041C0700X
Clinical Social Worker
Primary
LCSW-21993
AZ
Other
Enumeration date
08/15/2022
Last updated
06/13/2024
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