Individual
HAN NGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
350 W THOMAS RD, PHOENIX, AZ 85013-4409
(602) 406-3000
Mailing address
9201 N 83RD AVE UNIT 2081, PEORIA, AZ 85345-1608
(626) 404-8801
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/28/2023
Last updated
04/04/2024
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