| NPI | 1376273052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA ANN MARTINEZ Clinical Director Clinician 928-247-9602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 251S00000X | |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2023-07-20 |