Individual
MRS. TERESA AULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4315 N MARYVALE PKWY, PHOENIX, AZ 85031-1942
(623) 691-1715
(623) 691-1720
Mailing address
4315 N MARYVALE PKWY, PHOENIX, AZ 85031-1942
(623) 691-1715
(623) 691-1720
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPO12522
AZ
Other
Enumeration date
07/29/2014
Last updated
07/29/2014
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