| NPI | 1518190255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH M STODDARD Owner 623-293-2282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-13208) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-10994) |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2009-08-28 |