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General NPI Number Information
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NPI Number | 1578821591
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Entity Type | Organization
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Legal Business Name | ARIZONA FAMILY THERAPY & WELLNESS CENTER INC.
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Dates
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Enumeration Date | 04/27/2012
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Last Update Date | 04/27/2012
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Provider Practice Location Address
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Address Line | 2525 W GREENWAY RD STE 330
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City | PHOENIX
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State | AZ
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Zip | 85023-4226
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Country | US
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Telephone | 480-254-6395
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Fax | 623-209-8978
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Provider Business Mailing Address
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Address Line | 2525 W GREENWAY RD STE 330
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City | PHOENIX
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State | AZ
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Zip | 85023-4226
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Country | US
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Telephone | 480-254-6395
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Fax | 623-209-8978
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | MR. HARRY S. COLE JR.
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Credential | LMFT
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Telephone | 480-254-6395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT-10281
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License Number State | AZ
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