Individual
JERRY E NGALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
721 E FORGE AVE, MESA, AZ 85204-4916
(602) 775-0609
(480) 687-5301
Mailing address
721 E FORGE AVE, MESA, AZ 85204-4916
(602) 775-0609
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
374U00000X
Home Health Aide
Primary
—
AZ
Other
Enumeration date
08/01/2022
Last updated
10/04/2022
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