| NPI | 1003227190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIANE V ALVA Billing Manager 928-214-1070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2014-05-12 |