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COLLEEN LOUISE FOOTE-DERANGO MA, LISAC, SEP

Addiction (Substance Use Disorder) >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1659730539

Individual Registrant:
 COLLEEN LOUISE FOOTE-DERANGO MA, LISAC, SEP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
16724 WILLOW AVE.  YARNELL, AZ 85362 US
Tel: 928-231-2006  Fax: --

Contact information for business:
PO BOX 564  YARNELL, AZ 85362-0564 US
Tel: 928-231-2006  Fax: --

Registration Information:
NPI: 1659730539
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
AZLISAC-11512
N101YM0800XBehavioral Health & Social Service Providers
Counselor
Y101Y00000XBehavioral Health & Social Service Providers
Counselor

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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