Individual
MS. MIKALA EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
20806 N 31ST AVE, PHOENIX, AZ 85027-1729
(602) 576-4344
Mailing address
20806 N 31ST AVE, PHOENIX, AZ 85027-1729
(602) 576-4344
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
59414
AZ
Other
Enumeration date
02/23/2017
Last updated
02/23/2017
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