| NPI | 1205999430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY SCOTT GIBSON Owner/Partner 602-218-6901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ 11071) |
| 1041C0700X Social Worker, Clinical (Licence: AZ 11676) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2011-05-10 |