Individual
GEORGINA HELENE RUDZIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1211 W OCOTILLO ST, COOLIDGE, AZ 85128-9152
(541) 740-8642
(602) 455-4624
Mailing address
1211 W OCOTILLO ST, COOLIDGE, AZ 85128-9152
(541) 740-8642
(602) 455-4626
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
9229105
AZ
385HR2055X
Child Mental Illness Respite Care
9229105
AZ
Other
Enumeration date
11/14/2018
Last updated
04/23/2021
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