Most Relevant Information
Provider Data
| NPI Number: | 1003503301 |
| Provider Name: | EDEN A MCINTOSH LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | LPC-21044 |
Most Important Dates
| Enumeration Date: | 04/18/2023 |
| Last Updated: | 04/18/2023 |
Provider Practice Location
5805 S 52ND LN
LAVEEN
AZ
853392443
Practice Location Phone/Fax
| Phone: | 4807098236 |
| Fax: |
Provider Mailing Location
5805 S 52ND LN
LAVEEN
AZ
853392443
Provider Mailing Phone/Fax
| Phone: | 4807098236 |
| Fax: |