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1225888142
DIEDRICH WASSERBAUER
GLENDALE, AZ
NPI
1225888142
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: AZ LAC-19445)
Enumeration Date
2024-03-25
Last Update Date
2024-03-25
Business Address
DIEDRICH WASSERBAUER
7075 W BELL RD STE A-1
GLENDALE, AZ 85308-8546
Phone number: 602-488-6104
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Mailing Address
DIEDRICH WASSERBAUER
PO BOX 12468
GLENDALE, AZ 85318-2468
Phone number: 602-339-2457
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