Individual
JUANITA MAE RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. ED
Contact information
Practice address
15082 N 59TH AVE APT 157, GLENDALE, AZ 85306-5234
(623) 297-7686
Mailing address
15082 N 59TH AVE APT 157, GLENDALE, AZ 85306-5234
(623) 297-7686
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
AZ
Other
Enumeration date
08/13/2007
Last updated
08/29/2007
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