| NPI | 1811386394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY JOHN BRATKO Therapist 602-402-4474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: AZ LPC-14567) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health (Licence: AZ LISAC-11892) |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2015-01-21 |