| NPI | 1043930662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN M CRAIG Administrator 602-561-7806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic |
| 103TP2701X Psychologist, Group Psychotherapy | |
| Enumeration Date | 2022-09-01 |
| Last Update Date | 2022-09-01 |