| NPI | 1356796676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA F BIDLAKE Therapist 602-316-3488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MT 2356-LCSW) |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2016-04-25 |