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Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
3420 E SHEA BLVD STE 188, PHOENIX, AZ 85028-3354
(602) 529-6557
Mailing address
3420 E SHEA BLVD STE 188, PHOENIX, AZ 85028-3354

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
18299
AZ

Other

Enumeration date
10/25/2019
Last updated
10/25/2019
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