Organization
FAMILY SERVICE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARICE A. PARHAM M.A., LPC (CLINICAL DIRECTOR)
(602) 264-9891
Entity
Organization
Contact information
Practice address
943 S GILBERT RD, MESA, AZ 85204-4441
(602) 264-9891
Mailing address
15031 N 8TH AVE, PHOENIX, AZ 85023-5282
(928) 266-4151
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
LPC-12450
AZ
Other
Enumeration date
11/14/2011
Last updated
11/14/2011
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