Individual
SIRAELLE MADIATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4884 W CALLE DON ALBERTO, TUCSON, AZ 85757-1427
(310) 651-0013
Mailing address
4884 W CALLE DON ALBERTO, TUCSON, AZ 85757-1427
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH5450
AZ DEPT OF HEALTH SERVICES
AZ
Enumeration date
07/03/2018
Last updated
07/03/2018
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