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Individual

MISS GWEN ELLEN MADDIX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3436 W MALAPAI, PHX, AZ 85051
(602) 570-5742
Mailing address
4232 W WALTANN LN, PHOENIX, AZ 85053-3772
(602) 570-5742

Taxonomy

Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
385HR2055X
Child Mental Illness Respite Care
Primary

Other

Enumeration date
11/30/2006
Last updated
11/19/2025
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