| NPI | 1851801294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACRESHIA CASAUNDRA WITCHER CEO 602-828-5725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family (Licence: AZ OTC8341) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: AZ OTC8341) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2019-06-11 |