| NPI | 1629405337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONYA WHITAKER Manager/Therapist 623-850-8764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ 11290) |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2014-01-16 |