Individual
KEVIN M SOTO MARQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2345 S ALMA SCHOOL RD STE 105, MESA, AZ 85210-4013
(480) 206-4753
Mailing address
2345 S ALMA SCHOOL RD STE 105, MESA, AZ 85210-4013
(480) 271-5953
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LAC7472T
AZ
101YM0800X
Mental Health Counselor
Primary
LAC7472T
AZ
Other
Enumeration date
07/29/2022
Last updated
07/29/2022
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