Individual
MR. JOSEPH MICHAEL FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
4424 E BASELINE RD APT 2067, PHOENIX, AZ 85042-7440
(602) 510-4662
Mailing address
4424 E BASELINE RD APT 2067, PHOENIX, AZ 85042-7440
(602) 510-4662
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-16158
AZ
Other
Enumeration date
06/11/2018
Last updated
06/11/2018
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