Individual
PAT MEDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A./L.P.C.
Contact information
Practice address
21139 W CARAVAGGIO LN, WITTMANN, AZ 85361-8685
(623) 210-2561
Mailing address
15270 W BROOKSIDE LN, SURPRISE, AZ 85374-2450
(623) 210-2561
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-10557
AZ
Other
Enumeration date
11/11/2013
Last updated
11/11/2013
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