| NPI | 1023533940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE PETERSON Biller 520-441-4754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW16503) |
| Enumeration Date | 2017-08-11 |
| Last Update Date | 2017-08-11 |