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Individual

TYECHIA WEBB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
21239 N 24TH AVE APT 214, PHOENIX, AZ 85027-2524
(602) 402-2349
Mailing address
21239 N 24TH AVE APT 214, PHOENIX, AZ 85027-2524

Taxonomy

Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
9944280
AZ
385HR2055X
Child Mental Illness Respite Care
9944280
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9944280
AZ DEPT OF HEALTH SERVICES
AZ
Enumeration date
09/12/2019
Last updated
03/19/2020
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