Individual
MARY ANN MWENJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1302 S RICO, MESA, AZ 85204-6349
(480) 300-1432
Mailing address
1302 S RICO, MESA, AZ 85204-6349
(480) 300-1432
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
BH5129
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH5129
AZ DEPT OF HEALTH SERVICES
AZ
Enumeration date
07/20/2017
Last updated
07/21/2022
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