| NPI | 1548401821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE ANN SWANK Sole Proprietor 602-628-8580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-1901) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ 1446) |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2009-03-16 |