| NPI | 1689421034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENIS VINCENT KELSCH CEO 480-773-8386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2024-05-03 |