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General NPI Number Information
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NPI Number | 1427245943
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Entity Type | Individual
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Provider Name | LETTICIA BROWN-GAMBINO MS, NCC
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Gender | Female
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Dates
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Enumeration Date | 09/28/2007
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 7141 N 16TH ST
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City | PHOENIX
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State | AZ
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Zip | 85020-5542
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Country | US
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Telephone | 860-792-1124
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Fax |
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Provider Business Mailing Address
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Address Line | 7141 N 16TH ST UNIT 234
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City | PHOENIX
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State | AZ
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Zip | 85020-5541
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Country | US
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Telephone | 860-792-1124
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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-20848
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License Number State | AZ
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