Mark Gonchar, LASAC
Counselor, Addiction (Substance Use Disorder) in Rimrock, AZ. Individual provider (NPI-1).
NPI number1003399403
StatusActive
Last updated in NPPESSep 11, 2018
Details
- NPI
- 1003399403
- Entity type
- Individual (NPI-1)
- Name
- Mr. Mark Gonchar
- Credential
- LASAC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 11, 2018
- Last updated
- Sep 11, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 13156 | AZ | Yes |
Practice location
3095 E Coronado TrlRimrock, AZ 86335-5284
Phone 928-567-1322
Mailing address
Po Box 230Rimrock, AZ 86335-0230
Phone 928-567-1322
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