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Individual

YVETTE I HAUGHTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11275 N 99TH AVE LOT 117, PEORIA, AZ 85345-5479
(623) 687-8031
Mailing address
11275 N 99TH AVE, PEORIA, AZ 85345-5471

Taxonomy

Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
6371616
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6371616
THERAPEUTIC/PROFESSIONAL FOSTER HOME
AZ
Enumeration date
08/20/2020
Last updated
08/20/2020
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