Individual
DEIDRA WILLIAMS ANGULO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSD, LISAC
Contact information
Practice address
5704 E GABLE AVE, MESA, AZ 85206-6714
(602) 524-1986
Mailing address
5704 E GABLE AVE, MESA, AZ 85206-6714
(602) 524-1986
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11653
AZ
Other
Enumeration date
11/11/2020
Last updated
11/11/2020
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