Individual
TAMARA LURRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11864 W TONTO ST, AVONDALE, AZ 85323-9137
(404) 576-8185
Mailing address
11864 W TONTO ST, AVONDALE, AZ 85323-9137
(404) 576-8185
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH9707
AZ
Other
Enumeration date
03/22/2024
Last updated
03/22/2024
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