Individual
NICOLE FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
2925 E BLACKHAWK DR, PHOENIX, AZ 85050-4721
(480) 221-7264
Mailing address
2925 E BLACKHAWK DR, PHOENIX, AZ 85050-4721
(480) 221-7264
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3998362
AZ
Other
Enumeration date
04/27/2011
Last updated
04/27/2011
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