Organization
DAKOTA VALLEY HEALING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ULONDA OLD COYOTE (MEMBER)
(602) 565-4014
Entity
Organization
Contact information
Practice address
2680 S VAL VISTA DR STE 143, GILBERT, AZ 85295-1621
(602) 565-4014
Mailing address
2680 S VAL VISTA DR STE 143, GILBERT, AZ 85295-1621
(602) 565-4014
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801252200
—
AZ
Enumeration date
08/20/2021
Last updated
08/20/2021
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