Individual
DEBRA MARIE LAURIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LISAC
Contact information
Practice address
5062 N 19TH AVE, SUITE # 102, PHOENIX, AZ 85015-3225
(623) 939-6567
(623) 939-7365
Mailing address
5062 N 19TH AVE, SUITE # 102, PHOENIX, AZ 85015-3225
(623) 939-6567
(623) 939-7365
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-1673
AZ
Other
Enumeration date
12/02/2012
Last updated
12/02/2012
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