| NPI | 1417327735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LEE LECLERC Owner/Executive Clinical Director 480-282-4237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: AZ CSLG8022) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AZ 4299) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2018-08-20 |