Individual
HANG TO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM. D
Contact information
Practice address
178 E SHELDON ST, PRESCOTT, AZ 86301-3114
(928) 776-1936
Mailing address
5700 MARKET ST APT 2053, PRESCOTT VALLEY, AZ 86314-6523
(623) 302-1101
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S021576
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/16/2015
Last updated
09/18/2015
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