Provider Demographics
NPI:1215320890
Name:ADAMES, TRES MANUEL (MDIV, BCPC)
Entity type:Individual
Prefix:
First Name:TRES
Middle Name:MANUEL
Last Name:ADAMES
Suffix:
Gender:M
Credentials:MDIV, BCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9299 W OLIVE AVE
Mailing Address - Street 2:STE 212
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-8379
Mailing Address - Country:US
Mailing Address - Phone:480-525-7284
Mailing Address - Fax:
Practice Address - Street 1:9299 W OLIVE AVE
Practice Address - Street 2:STE 212
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-8379
Practice Address - Country:US
Practice Address - Phone:480-525-7284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-06
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral