Individual
MISTY D ADAME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EDD LPC
Contact information
Practice address
21448 N 75TH AVE STE 6, GLENDALE, AZ 85308-5978
(623) 572-8053
Mailing address
22341 N 79TH DR, PEORIA, AZ 85383-2157
(602) 403-1988
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
14458
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689082265
NPI
AZ
Enumeration date
01/08/2020
Last updated
01/08/2020
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