Individual
SOPHIA FASANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2000 W BETHANY HOME RD, PHOENIX, AZ 85015-2443
(602) 246-5521
Mailing address
PO BOX 71711, PHOENIX, AZ 85050-1012
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/29/2024
Last updated
03/29/2024
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