Individual
CLARISA DIAZ MORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2217 W GLENDALE AVE, PHOENIX, AZ 85021-7729
(623) 915-8400
Mailing address
25647 W LYNNE LN, BUCKEYE, AZ 85326-2181
(951) 623-0476
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
273811
AZ
Other
Enumeration date
08/05/2022
Last updated
08/05/2022
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