Individual
KRISTINE LOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1942 S AVENIDA URSA, TUCSON, AZ 85710-5418
(520) 907-6327
Mailing address
4000 N CENTRAL AVE STE 100, PHOENIX, AZ 85012-3520
(602) 283-1573
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH10631
AZ
385H00000X
Respite Care
BH10631
AZ
Other
Enumeration date
03/25/2025
Last updated
03/25/2025
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