Individual
ERIC THISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LAC
Contact information
Practice address
16620 N 40TH ST STE G1, PHOENIX, AZ 85032
(602) 363-0629
Mailing address
16620 N 40TH ST STE G1, PHOENIX, AZ 85032-3351
(602) 363-0629
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-22156
AZ
Other
Enumeration date
03/15/2021
Last updated
09/18/2023
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