TARA FUSILLO

PHOENIX, AZ
NPI1356113179
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence:   LASAC-15247)
Additional Taxonomies101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ  15247)
Enumeration Date2023-10-25
Last Update Date2023-10-25
Business Address
TARA FUSILLO LASAC
3050 W AGUA FRIA FWY STE 150
PHOENIX, AZ 85027-3998
Phone number: 928-713-1619
Mailing Address
TARA FUSILLO LASAC
3050 W AGUA FRIA FWY STE 150
PHOENIX, AZ 85027-3998
Phone number: 928-713-1619