Organization
HEALING SERVICE AGENCY LLC
Active
Other names
HSA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENT PAUL MARSHALL LCSW (SOLE OWNER)
(623) 850-5400
Entity
Organization
Contact information
Practice address
17505 N 79TH AVE STE 203, GLENDALE, AZ 85308-8726
(623) 850-5400
(623) 321-7850
Mailing address
17505 N 79TH AVE STE 203, GLENDALE, AZ 85308-8726
(623) 850-5400
(623) 321-7850
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
LCSW-17245
AZ
Other
Enumeration date
07/08/2018
Last updated
07/31/2020
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