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Individual

MRS. CRISANTA T HANNAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NONE

Contact information

Practice address
7151 W VALLEY STREAM DRIVE, TUCSON, AZ 85757-1422
(520) 888-0810
(520) 319-5491
Mailing address
7151 W VALLEY STREAM DRIVE, TUCSON, AZ 85757-1422
(520) 888-0810
(520) 319-5491

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
2721
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
921503
AHCCCS
AZ
Enumeration date
01/31/2007
Last updated
01/18/2008
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