Individual
KRISONA HEUSTED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3901 E EMILE ZOLA AVE, PHOENIX, AZ 85032-6225
(623) 314-4500
Mailing address
3901 E EMILE ZOLA AVE, PHOENIX, AZ 85032-6225
(623) 314-4500
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
4504103
AZ
Other
Enumeration date
02/01/2013
Last updated
02/01/2013
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