Individual
MRS. DALENE VASCONCELLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
32375 N GANTZEL RD, SAN TAN VALLEY, AZ 85143-5110
(480) 474-6100
Mailing address
32375 N GANTZEL RD, SAN TAN VALLEY, AZ 85143-5110
(480) 474-6100
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP054328
AZ
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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