Individual
MICHELLE CARMEN DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
SR 264 & HWY 191, GANADO, AZ 86505
(928) 755-4586
(928) 755-4747
Mailing address
PO BOX 364, ST MICHAELS, AZ 86511-0364
(928) 797-9770
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
UA2022082509
AZ
Other
Enumeration date
05/11/2023
Last updated
05/11/2023
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