| NPI | 1184107096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA VAN WAGENEN BERMUDEZ Licensed Clinical Social Worker 602-741-8537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AZ 12320) |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2018-09-07 |