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General NPI Number Information
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NPI Number | 1104090992
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Entity Type | Organization
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Legal Business Name | BATES COUNSELING & CONSULTATION, LLC
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 04/14/2008
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Provider Practice Location Address
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Address Line | 2101 E BROADWAY RD SUITE 5
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City | TEMPE
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State | AZ
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Zip | 85282-1879
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Country | US
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Telephone | 480-829-9435
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Fax |
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Provider Business Mailing Address
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Address Line | 2101 E BROADWAY RD STE 5
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City | TEMPE
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State | AZ
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Zip | 85282-1735
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Country | US
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Telephone | 480-829-9435
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Fax |
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Authorized Official
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Title or Position | PROFESSIONAL COUNSELOR
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Name | CHRISTINA BATES
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Credential |
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Telephone | 480-829-9435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC12145
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License Number State | AZ
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