Individual
HENOK TEKA KASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6315 W WARNER ST, PHOENIX, AZ 85043-0139
(602) 386-6212
Mailing address
6315 W WARNER ST, PHOENIX, AZ 85043-0139
(602) 386-6212
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH7864
AZ
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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