Individual
MRS. MICHELLE MARIE KOMETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11201 N. TATUM BLVD, SUITE 300, PHOENIZ, AZ 85028
(480) 204-3893
Mailing address
11201 NORTH TATUM BLVD, SUITE 300, PHOENIX, AZ 85028
(480) 204-3893
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-17215
AZ
Other
Enumeration date
08/31/2018
Last updated
10/06/2021
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