Individual
LISA DIANNE CONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
7254 E SOUTHERN AVE, SUITE 123, MESA, AZ 85209-2786
(480) 495-5356
Mailing address
33444 N KARI RD, QUEEN CREEK, AZ 85142-3073
(480) 495-5356
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC12225
AZ
Other
Enumeration date
03/20/2008
Last updated
02/07/2012
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