Individual
MICHEAL DEAN LUTTRULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAAC
Contact information
Practice address
31636 N CACTUS DR, SAN TAN VALLEY, AZ 85143-7242
(480) 522-0566
Mailing address
31636 N CACTUS DR, SAN TAN VALLEY, AZ 85143-7242
(480) 522-0566
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CO60703545
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP60969656
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LAAC-15461
AZ
Other
Enumeration date
01/30/2019
Last updated
03/18/2025
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