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Individual

JEANETTE PERRY-BRUNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4515 W COLES RD, LAVEEN, AZ 85339-2127
(480) 516-2528
Mailing address
4515 W COLES RD, LAVEEN, AZ 85339-2127
(480) 516-2528

Taxonomy

Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
1234448
AZ

Other

Enumeration date
10/06/2014
Last updated
10/06/2014
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