Individual
THEA MARIE MOTYKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5001 W JO ANN CIR, GLENDALE, AZ 85308-3307
(602) 456-9633
Mailing address
PO BOX 10592, GLENDALE, AZ 85318-0592
(602) 456-9633
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/28/2024
Last updated
09/28/2024
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