| NPI | 1104836634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BURDETTE O LEIKVOLL Owner 623-974-0357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-0331) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |