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Individual

LIBERTY VIERRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7310 N BADER RD, FLAGSTAFF, AZ 86001-8013
(928) 814-8322
Mailing address
7310 N BADER RD, FLAGSTAFF, AZ 86001-8013
(928) 814-8322

Taxonomy

Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
4473415
AZ

Other

Enumeration date
07/16/2013
Last updated
07/16/2013
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