Individual
WALIK HARGETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 N. LENZNER AVE APT 776B, SIERRA VISTA, AZ 85635
(520) 732-3197
Mailing address
INTERMOUNTAIN CENTERS FOR HUMAN DEVELOPMENT INC, 994 S HARRISON RD, TUCSON, AZ 85748
(520) 721-1887
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
8126756
AZ
Other
Enumeration date
04/14/2017
Last updated
02/26/2020
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