Individual
MR. NICHOLAS GREGORY BASALYGA IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 E MABEL ST, TUCSON, AZ 85705-6654
(570) 575-4323
Mailing address
125 E MABEL ST, TUCSON, AZ 85705-6654
(570) 575-4323
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
20617
AZ
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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