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1760191209
LISA MARIE MEDEIROS
GILBERT, AZ
NPI
1760191209
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: AZ LAC-21287)
Enumeration Date
2022-11-22
Last Update Date
2022-11-22
Business Address
LISA MARIE MEDEIROS MS, LAC
3303 E BASELINE RD STE 109
GILBERT, AZ 85234-2739
Phone number: 480-900-8765
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Mailing Address
LISA MARIE MEDEIROS MS, LAC
9247 S 15TH AVE
PHOENIX, AZ 85041-8609
Phone number: 480-231-4468
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