Individual
KENNEDY OTIENO OYALO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9858 E HAY LOFT DR, FLORENCE, AZ 85132-7369
(480) 578-3995
Mailing address
9858 E HAY LOFT DR, FLORENCE, AZ 85132-7369
(480) 578-3995
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
11745797
AZ
251S00000X
Community/Behavioral Health Agency
Primary
11745797
AZ
251S00000X
Community/Behavioral Health Agency
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Other
Enumeration date
06/19/2023
Last updated
06/26/2023
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