| Empact-spc | |
|
4425 W Olive Ave Suite 194 Glendale AZ 85302-3843 | |
| (480) 784-1514 | |
| Not Available |
| Full Name | Empact-spc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4425 W Olive Ave, Glendale, Arizona |
| Authorized Official Name and Position | Sondra Kay Wilkinson (FAMILY THERAPIST) |
| Authorized Official Contact | 4807841514 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Empact-spc 6629 N 90th Dr Glendale AZ 85305-2043 Ph: (623) 872-7468 | Empact-spc 4425 W Olive Ave Suite 194 Glendale AZ 85302-3843 Ph: (480) 784-1514 |
| NPI Number | 1164508875 |
|---|---|
| Provider Enumeration Date | 10/27/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164508875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LPC-12392 (Arizona) | Primary |
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