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Individual

MS. MARYROSE TRONGCO GANDEZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
NAVAJO ROUTE 12, WINDOW ROCK UNIFIED SCHOOL DISTRICT, FORT DELIANCE, AZ 86504
(920) 729-6768
(928) 729-7630
Mailing address
PO BOX 2814, FORT DEFIANCE, AZ 86504
(928) 729-5045

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
889454
AHCCCS
AZ
Enumeration date
06/15/2007
Last updated
07/26/2007
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