Individual
JOLLEY D DEMAIH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10802 N 43RD, GLENDALE, AZ 85304
(602) 314-6064
Mailing address
12371 W HAZELWOOD ST, AVONDALE, AZ 85392-4277
(602) 200-4804
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
05/01/2024
Last updated
05/01/2024
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