| NPI | 1669608535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY LYNN PAUL Therapist/Owner 520-400-3970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AZ LPC1626) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: AZ LISAC2397) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2010-05-25 |