Individual
MRS. LATRIECE MADDOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
41768 W BARCELONA DR, MARICOPA, AZ 85138-4445
(562) 506-3974
Mailing address
41768 W BARCELONA DR, MARICOPA, AZ 85138-4445
(562) 506-3974
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
225170
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163188
—
AZ
Enumeration date
07/22/2022
Last updated
10/07/2025
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