Individual
MS. MANERVIA GENETTE GENTLE WILEMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13000 N 103RD AVE STE 74, SUN CITY, AZ 85351-3056
(623) 533-5138
Mailing address
13000 N 103RD AVE STE 74, SUN CITY, AZ 85351-3056
(623) 533-5138
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC15980
AZ
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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