Individual
TARA BERKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2461 W KIT CARSON TRL, ANTHEM, AZ 85086-1878
(602) 326-2312
Mailing address
2461 W KIT CARSON TRL, ANTHEM, AZ 85086-1878
(602) 326-2312
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
1406917
AZ
Other
Enumeration date
03/25/2009
Last updated
03/25/2009
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