| NPI | 1417380874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ANDREW MALM Owner 602-326-7438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-12213) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2013-08-20 |