Individual
MIREYA J ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6153 W OLIVE AVE, GLENDALE, AZ 85302-4564
(602) 685-6120
Mailing address
3003 N CENTRAL AVE, SUITE 200, PHOENIX, AZ 85012-2902
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC 14101
AZ
Other
Enumeration date
06/27/2013
Last updated
06/27/2013
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