Individual
MRS. MICHELE DONALDSON HOLBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LASAC
Contact information
Practice address
3825 N 24TH ST, PHOENIX, AZ 85016-6512
(602) 248-8886
Mailing address
3825 N 24TH ST, PHOENIX, AZ 85016-6512
(602) 248-8886
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CADAC 2071
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
ICADC 711815
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LASAC-13027
AZ
Other
Enumeration date
08/22/2013
Last updated
08/22/2013
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