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Maryann Fully, L/Ac/, Dial. Ac. 3920 N. Campbell Avenue Tucson, AZ 85719 Phone: (520) 4954400 Fax: (520) 4955400New Patient Intake Acupuncture Name Today's date: / / Address City State Zip Birthdate
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Maryann Tully LAC DIP is likely a reference to a specific diploma or certification held by an individual named Maryann Tully, potentially in the field of Licensed Art Counseling (LAC) or similar disciplines.
Individuals seeking to practice in a specific field requiring certification or licensure may be required to file for the Maryann Tully LAC DIP, typically within roles related to counseling or art therapy.
To fill out the Maryann Tully LAC DIP form, one should provide personal identification information, relevant educational background, proof of completed qualifications, and possibly references or additional documentation as required by the certifying body.
The purpose of the Maryann Tully LAC DIP is to certify individuals in their professional qualifications and readiness to practice in the field of Licensed Art Counseling or related areas.
The information that must be reported on the Maryann Tully LAC DIP typically includes the applicant's name, contact information, educational qualifications, training experiences, and relevant license or certification details.
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