Individual
EMILY FANKHAUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
3707 E SOUTHERN AVE STE 2028, MESA, AZ 85206-6214
(602) 693-3915
Mailing address
3707 E SOUTHERN AVE STE 2028, MESA, AZ 85206-6214
(602) 693-3915
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-22426
AZ
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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