EDWARD OMAR ONTIVEROS

TEMPE, AZ
NPI1457074098
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: AZ  LAC-21115)
Enumeration Date2022-09-20
Last Update Date2022-09-20
Business Address
Mr. EDWARD OMAR ONTIVEROS LAC
4801 S LAKESHORE DR STE 106
TEMPE, AZ 85282-7156
Phone number: 480-525-0058
Mailing Address
Mr. EDWARD OMAR ONTIVEROS LAC
3924 E MINTON ST
PHOENIX, AZ 85042-6229
Phone number: 602-821-9386
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