Individual
NANNETTE NEWTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16415 N 168TH AVE, SURPRISE, AZ 85388-1330
(520) 582-7396
Mailing address
2025 N 3RD ST STE 300, PHOENIX, AZ 85004-1486
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH7304
AZ
385HR2055X
Child Mental Illness Respite Care
BH7304
AZ
Other
Enumeration date
02/22/2022
Last updated
05/01/2024
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