| NPI | 1881916526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA CALLOZZO Provider 480-963-3020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC22335) |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2010-02-22 |