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Individual

DR. DERRAINNYA FUENTES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
19935 E CHANDLER HEIGHTS RD, QUEEN CREEK, AZ 85142-9350
(602) 670-2115
Mailing address
19935 E CHANDLER HEIGHTS ROAD, QUEEN CREEK, AZ 85142
(602) 670-2115

Taxonomy

Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
4439413
AZ

Other

Enumeration date
02/20/2017
Last updated
02/20/2017
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