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Individual

DELORES DIANNE YOUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISAC

Contact information

Practice address
15270 W BROOKSIDE LN, SURPRISE, AZ 85374
(928) 231-1032
Mailing address
1660 W VERDE DR, WICKENBURG, AZ 85390
(928) 231-1032

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11359
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101YA0400X
COUNSELOR-ADDICTIONS
AZ
Enumeration date
04/01/2009
Last updated
04/01/2009
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