Individual
LISA MARIE MEDEIROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAC
Contact information
Practice address
3303 E BASELINE RD STE 109, GILBERT, AZ 85234-2739
(480) 900-8765
Mailing address
9247 S 15TH AVE, PHOENIX, AZ 85041-8609
(480) 231-4468
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-21287
AZ
Other
Enumeration date
11/22/2022
Last updated
11/22/2022
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