Individual
CARLOS GODOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6108 E BRAMBLE ST, TUCSON, AZ 85756
(520) 437-2437
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
6954828
AZ
Other
Enumeration date
05/26/2015
Last updated
11/12/2019
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