Individual
ROSALINDA CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2376 N CALLE EMPALME, NOGALES, AZ 85621-3346
(520) 975-7005
(520) 407-5398
Mailing address
PO BOX 86537, TUCSON, AZ 85754-6537
(520) 721-1887
(520) 407-5398
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
8477574
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8477574
THERAPEUTIC FOSTER CARE
AZ
Enumeration date
11/25/2020
Last updated
11/25/2020
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