Individual
JUSTIN MABANY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9525 W MINNEZONA AVE, PHOENIX, AZ 85037-1349
(623) 872-5454
Mailing address
9525 W MINNEZONA AVE, PHOENIX, AZ 85037-1349
(602) 384-0669
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
BH6750
AZ
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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