| NPI | 1942587217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARICE A. PARHAM Clinical Director 602-264-9891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: AZ LPC-12450) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2011-11-14 |