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1063585446
VAN EDEN CAVE
GLENDALE, AZ
NPI
1063585446
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: AZ LPC-2363)
Enumeration Date
2006-11-15
Last Update Date
2007-07-08
Business Address
-- VAN EDEN CAVE MC, LPC
7075 W BELL RD SUITE 3
GLENDALE, AZ 85308-8546
Phone number: 602-485-1245
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Mailing Address
-- VAN EDEN CAVE MC, LPC
20165 N 67TH AVE SUITE 122A PMB 144
GLENDALE, AZ 85308-7002
Phone number: 602-485-1245
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