Individual
MRS. THERESE MAE' TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
10358 N 78TH AVE, PEORIA, AZ 85345-6782
(623) 486-2277
Mailing address
10358 N 78TH AVE, PEORIA, AZ 85345-6782
(623) 486-2277
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP045474
AZ
Other
Enumeration date
08/24/2009
Last updated
08/24/2009
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