NPI | 1154750529 |
---|---|
Entity Type | Organization |
Authorized Contact | DARCY KUSAK Member, Statutory Agent, Founder 480-748-5006 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-13028) |
Enumeration Date | 2013-11-06 |
Last Update Date | 2016-10-19 |