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1598086076
MICHAEL ALLEN VANSLYKE
CASA GRANDE, AZ
NPI
1598086076
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ LISAC-10197)
Enumeration Date
2010-06-18
Last Update Date
2010-06-18
Business Address
-- MICHAEL ALLEN VANSLYKE BA, LISAC
6540 N CHOLLA LN
CASA GRANDE, AZ 85194-6896
Phone number: 520-836-1675
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Mailing Address
-- MICHAEL ALLEN VANSLYKE BA, LISAC
6540 N CHOLLA LN
CASA GRANDE, AZ 85194-6896
Phone number: 520-836-1675
Copy
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