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Individual

SAMANTHA COUSINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
553 E. PLAZA CIR, LITCHFIELD PARK, AZ 85340-4930
(623) 535-6318
Mailing address
553 E PLAZA CIR, LITCHFIELD PARK, AZ 85340-4930

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP029186
AZ

Other

Enumeration date
11/16/2007
Last updated
11/16/2007
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