Individual
MRS. LAURIE MARIE BANNICK-JUNGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.E.
Contact information
Practice address
4650 W. SWEETWATER AVENUE, GLENDALE, AZ 85304
(602) 347-2600
Mailing address
3137 W. ZACHARY DRIVE, PHOENIX, AZ 85027
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
621947
—
AZ
Enumeration date
05/01/2007
Last updated
07/25/2007
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