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1144643628
BEVAN GOTTLIEB
PRESCOTT, AZ
NPI
1144643628
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: AZ 10822)
Enumeration Date
2014-02-04
Last Update Date
2014-02-04
Business Address
BEVAN GOTTLIEB LISAC
115 E GOODWIN ST SUITE C
PRESCOTT, AZ 86303-3926
Phone number: 928-533-2411
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Mailing Address
BEVAN GOTTLIEB LISAC
520 ELLENWOOD DR
PRESCOTT, AZ 86303-4122
Phone number:
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