Individual
SOPHIE GASTELUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20521 E CANARY CT, QUEEN CREEK, AZ 85142-3406
(208) 420-6678
Mailing address
484 W TOLEDO ST, CHANDLER, AZ 85225-4510
(480) 306-3827
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
230136
AZ
Other
Enumeration date
08/26/2019
Last updated
08/26/2019
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