Individual
KELLI PACICCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.A.C.
Contact information
Practice address
2600 E SOUTHERN AVE STE C3, TEMPE, AZ 85282-7609
(602) 859-9744
(602) 865-8710
Mailing address
2600 E SOUTHERN AVE STE C3, TEMPE, AZ 85282-7609
(602) 859-9744
(602) 865-8710
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-15199
AZ
Other
Enumeration date
09/30/2014
Last updated
09/30/2014
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