Individual
ANGELA L BAZEMORE QUAYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DBH, CFNC, RDMS, SAP
Contact information
Practice address
29697 N 69TH DR, PEORIA, AZ 85383-3178
(443) 636-0686
(602) 532-7857
Mailing address
29697 N 69TH DR, PEORIA, AZ 85383-3178
(443) 636-0686
(602) 532-7857
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
2471S1302X
Sonography Radiologic Technologist
Primary
108395
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
814313295
—
AZ
Enumeration date
03/31/2017
Last updated
04/15/2025
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