Individual
NADIA JOLIE CASSANGUIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12379 W WHYMAN AVE, AVONDALE, AZ 85323-1241
(623) 313-0532
Mailing address
12379 W WHYMAN AVE, AVONDALE, AZ 85323-1241
(623) 313-0532
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
9557460
AZ
385HR2055X
Child Mental Illness Respite Care
9557460
AZ
Other
Enumeration date
02/23/2023
Last updated
02/23/2023
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