Individual
HEATHER SIMONE MALISSA SUE ANDERSON NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2142 E ELECTRA LN, PHOENIX, AZ 85024-8608
(602) 538-3801
Mailing address
2142 E ELECTRA LN, PHOENIX, AZ 85024-8608
(602) 538-3801
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
9315848
AZ
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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