is a Clinical in Marana, Arizona. practices all healthcare services and medical treatments related to Clinical. The NPI Number for is 1275790362. The last update date is .
's current location address is Po Box 188, Marana, Arizona. You can contact this provider via phone number 5206821091 and fax number 5206824132. The mailing address for is Po Box 188, Marana, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | Po Box 188, Marana, Arizona |
| Phone Number | 5206821091 |
| Fax Number | 5206824132 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1275790362 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | Po Box 188 |
|---|---|
| City | Marana |
| State | Arizona (AZ) |
| Post Code | 856530188 |
| Phone Number | 5206821091 |
| Fax Number | 5206824132 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LCSW-11794 |
|
Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 988610 | AZ | -- |
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