MICHAEL ALLEN VANSLYKE

CASA GRANDE, AZ
NPI1598086076
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ  LISAC-10197)
Enumeration Date2010-06-18
Last Update Date2010-06-18
Business Address
-- MICHAEL ALLEN VANSLYKE BA, LISAC
6540 N CHOLLA LN
CASA GRANDE, AZ 85194-6896
Phone number: 520-836-1675
Mailing Address
-- MICHAEL ALLEN VANSLYKE BA, LISAC
6540 N CHOLLA LN
CASA GRANDE, AZ 85194-6896
Phone number: 520-836-1675