Organization
COGNITIVE BEHAVIORAL THERAPY LEARNING GROUP LLC
Active
Organization
COGNITIVE BEHAVIORAL THERAPY LEARNING GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN DOLENCE (PROVIDER)
(520) 401-1978
Entity
Organization
Contact information
Practice address
330 E 16TH ST, TUCSON, AZ 85701-2811
(520) 336-2964
Mailing address
PO BOX 43551, TUCSON, AZ 85733-3551
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12906
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12906
STATE LICENSE
AZ
Enumeration date
10/18/2017
Last updated
10/18/2017
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