Individual
MR. JOSE MENDIVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
735 E FILLMORE ST, PHOENIX, AZ 85006-3324
(602) 257-4851
(602) 257-4852
Mailing address
7043 W PURDUE AVE, PEORIA, AZ 85345-8857
(623) 878-0436
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
—
AZ
Other
Enumeration date
04/26/2007
Last updated
07/26/2007
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