Individual
TRACEY A. DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8932 W HAMMOND LN, TOLLESON, AZ 85353-6956
(623) 536-5860
Mailing address
8932 W HAMMOND LN, TOLLESON, AZ 85353-6956
(623) 536-5860
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
525702
AZ
Other
Enumeration date
02/20/2009
Last updated
02/20/2009
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