Individual
AIDA LACEVIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 222-2752
(602) 222-2723
Mailing address
4135 E COOLBROOK AVE, PHOENIX, AZ 85032-2253
(602) 222-2752
(602) 222-2723
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
33724
AZ
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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