BEVAN GOTTLIEB

PRESCOTT, AZ
NPI1144643628
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ  10822)
Enumeration Date2014-02-04
Last Update Date2014-02-04
Business Address
-- BEVAN GOTTLIEB LISAC
115 E GOODWIN ST SUITE C
PRESCOTT, AZ 86303-3926
Phone number: 928-533-2411
Mailing Address
-- BEVAN GOTTLIEB LISAC
520 ELLENWOOD DR
PRESCOTT, AZ 86303-4122
Phone number: