Individual
MS. KATHLEEN JO GUILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MC
Contact information
Practice address
483 W. SEED FARM RD., NEW BEGINNINGS BUILDING, SACATON, AZ 85247
(602) 528-7179
(602) 528-1374
Mailing address
483 W. SEED FARM RD., NEW BEGINNINGS BUILDING, SACATON, AZ 85247
(602) 528-7179
(602) 528-1374
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC12771
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
326214
—
AZ
Enumeration date
07/21/2008
Last updated
07/21/2008
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