Individual
MS. AVA ALEXANDER ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6915 S 37TH GLEN, PHOENIX, AZ 85041-6175
(602) 276-1112
Mailing address
6915 S 37TH GLEN, PHOENIX, AZ 85041-6175
(602) 276-1112
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
3796
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
869604
AHCCCS ID NUMBER
AZ
Enumeration date
11/28/2006
Last updated
06/24/2008
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