Individual
DIANE DE GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISAC
Contact information
Practice address
5801 N 51ST AVE, GLENDALE, AZ 85301-6057
(602) 685-6000
(602) 930-0358
Mailing address
3003 N CENTRAL AVE STE 400, PHOENIX, AZ 85012-2929
(602) 685-6000
(602) 302-7925
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-11685
AZ
Other
Enumeration date
02/03/2015
Last updated
08/25/2021
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