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Individual

MS. VIRGINIA RUTH ARCHIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1502 E CARSON RD, PHOENIX, AZ 85042-5621
(602) 276-7690
Mailing address
1502 E CARSON RD, PHOENIX, AZ 85042-5621
(602) 276-7690

Taxonomy

Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
1372
AS
385HR2055X
Child Mental Illness Respite Care
1372
AZ

Other

Enumeration date
03/26/2007
Last updated
03/13/2020
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