| NPI | 1992227235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY DELUCA Billing Manager 602-741-3077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AZ 16034) |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2019-10-29 |