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General NPI Number Information
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NPI Number | 1083042741
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Entity Type | Individual
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Provider Name | APRIL LAIN M.ED, LISAC
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Gender | Female
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 12/27/2013
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Provider Practice Location Address
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Address Line | 15270 W BROOKSIDE LN STE 121
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City | SURPRISE
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State | AZ
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Zip | 85374-2449
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Country | US
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Telephone | 623-432-0668
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Fax |
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Provider Business Mailing Address
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Address Line | 21139 W CARAVAGGIO LN
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City | WITTMANN
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State | AZ
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Zip | 85361-8685
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Country | US
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Telephone | 623-210-5951
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LISAC10221
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License Number State | AZ
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