Individual
MR. MAURICE NICHOLAS WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1213 E ECHO LN, PHOENIX, AZ 85020-3827
(602) 242-0842
Mailing address
1213 E ECHO LN, PHOENIX, AZ 85020-3827
(602) 242-0842
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
10990
AZ
Other
Enumeration date
01/05/2007
Last updated
07/08/2007
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