Organization
MISS GHOST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN CORAH HITCHCOCK (OWNER)
(602) 614-4471
Entity
Organization
Contact information
Practice address
11260 N TATUM BLVD, PHOENIX, AZ 85028-2307
(602) 614-4471
Mailing address
11260 N TATUM BLVD, PHOENIX, AZ 85028-2307
(602) 614-4471
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
06/14/2024
Last updated
07/26/2024
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