Individual
SUNNY MAKOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2405 STONEWALL ST, GREENVILLE, TX 75401-3349
(903) 454-3300
(903) 454-3307
Mailing address
2550 W UNION HILLS DR, PHOENIX, AZ 85027-5163
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
250872
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
844501
TX
Other
Enumeration date
09/24/2019
Last updated
08/23/2024
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