JOHN SMITH

MESA, AZ
NPI1861924722
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: AZ  LISAC-10251)
Enumeration Date2017-03-30
Last Update Date2017-03-30
Business Address
-- JOHN SMITH
245 N CENTENNIAL WAY
MESA, AZ 85201-6702
Phone number: 602-908-7904
Mailing Address
-- JOHN SMITH
245 N CENTENNIAL WAY
MESA, AZ 85201-6702
Phone number: 602-908-7904