| NPI | 1184107096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA VAN WAGENEN BERMUDEZ Licensed Clinical Social Worker 480-701-8828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2025-01-27 |