| NPI | 1457899783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW FITZGERALD Billing Manager 480-269-2971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ 15857) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2017-02-07 |