Individual
ADENA MARIE MCGORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9612 W SUPERIOR AVE, TOLLESON, AZ 85353-8586
(602) 487-4593
Mailing address
9612 W SUPERIOR AVE, TOLLESON, AZ 85353-8586
(602) 487-4593
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
2281572
AZ
Other
Enumeration date
08/25/2010
Last updated
08/25/2010
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