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Individual

BARBARA SUE IKNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8877 N HERSEY WAY, TUCSON, AZ 85742-8870
(520) 241-0389
Mailing address
8877 N HERSEY WAY, TUCSON, AZ 85742-8870
(520) 241-0389

Taxonomy

Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
3110359
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3110359
AZ OLCR FOSTER CARE LICENSE
AZ
Enumeration date
11/22/2011
Last updated
11/22/2011
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