| NPI | 1982289062 |
|---|---|
| Doing Business As | TEEN OUT REACH SERVICES |
| Entity Type | Organization |
| Authorized Contact | AMANDA REANE JOHNSON Director 480-696-0338 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 282NC0060X General Acute Care Hospital, Critical Access |
| Enumeration Date | 2021-03-10 |
| Last Update Date | 2021-06-03 |