| NPI | 1740423607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA GENEVA GONZALES Owner/Member 602-327-0834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LPC13196) |
| Additional Taxonomies | 251S00000X (Licence: AZ LPC13196) |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2010-04-28 |