Individual
BRAD DEROMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15815 S LAKEWOOD PKWY W APT 2016, PHOENIX, AZ 85048-7291
(760) 613-6861
Mailing address
15815 S LAKEWOOD PKWY W APT 2119, PHOENIX, AZ 85048-7294
(760) 613-6861
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LIAC-155343
AZ
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
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Other
Enumeration date
07/27/2021
Last updated
10/23/2024
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