Individual
LISA MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10446 N 74TH ST STE 150, SCOTTSDALE, AZ 85258-1045
(888) 663-7847
Mailing address
PO BOX 412, SCOTTSDALE, AZ 85252-0412
(480) 414-2596
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10353
AZ
Other
Enumeration date
04/16/2019
Last updated
04/16/2019
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