Organization
SEQUELCARE OF ARIZONA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE HIRZ (HCTC PROVIDER)
(928) 777-3280
Entity
Organization
Contact information
Practice address
8603 E EASTRIDGE RD, PRESCOTT VALLEY, AZ 86314-8562
(928) 777-3280
Mailing address
3656 PACKSADDLE RD, KINGMAN, AZ 86401-6524
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
467011
AZ
Other
Enumeration date
05/21/2015
Last updated
05/21/2015
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