Provider Demographics
NPI:1912155367
Name:SONORAN LIFE SOLUTIONS, INC.
Entity Type:Organization
Organization Name:SONORAN LIFE SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:ALYSE
Authorized Official - Last Name:GIROD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:162-397-4333
Mailing Address - Street 1:13460 N 94TH DR
Mailing Address - Street 2:K-3
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4835
Mailing Address - Country:US
Mailing Address - Phone:623-974-3333
Mailing Address - Fax:
Practice Address - Street 1:13460 N 94TH DR
Practice Address - Street 2:K-3
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4835
Practice Address - Country:US
Practice Address - Phone:623-974-3333
Practice Address - Fax:623-974-3390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC2537101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty