| NPI | 1205353083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN STATT Member 520-447-7440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AZ 10409) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-23 |