Organization
DERA HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENITA MARTIN DNP (DNP)
(206) 816-4594
Entity
Organization
Contact information
Practice address
10 W MINNEZONA AVE, PHOENIX, AZ 85013-4933
(206) 816-4594
Mailing address
10 W MINNEZONA AVE, PHOENIX, AZ 85013-4933
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
02/05/2022
Last updated
02/05/2022
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