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Individual

DIANE DETWILER-ZAPP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
315 W APACHE ST, WICKENBURG, AZ 85390-1213
(623) 910-6246
Mailing address
PO BOX 1508, WICKENBURG, AZ 85358-1508
(623) 910-6246

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-10453
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
837031
AZ
01
AZ0618640
AZ. BCBS
AZ
Enumeration date
11/06/2006
Last updated
07/09/2007
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