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Individual

ERIK MICHAEL GAGNON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3821 N 15TH AVE, PHOENIX, AZ 85015-5545
(602) 535-9296
Mailing address
3821 N 15TH AVE, PHOENIX, AZ 85015-5545
(602) 535-9296

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LISAC-10189
AZ

Other

Enumeration date
06/23/2020
Last updated
11/02/2021
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