Individual
FAUSTINA PREMPEH-COATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9548 W AGORA LN, TOLLESON, AZ 85353-4564
(602) 930-5974
(623) 303-1526
Mailing address
15827 W MONROE ST, GOODYEAR, AZ 85338-6896
(602) 930-5974
(623) 303-1526
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
DDH3872
AZ
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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