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General NPI Number Information
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NPI Number | 1396468021
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Entity Type | Individual
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Provider Name | WESLEY LUFFMAN
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Gender | Male
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 20 E THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85012-3110
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Country | US
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Telephone | 800-843-7279
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Fax |
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Provider Business Mailing Address
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Address Line | 22942 E ROSA RD
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-2030
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Country | US
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Telephone | 480-714-4063
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-18800
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License Number State | AZ
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