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PATRICIA D BOONE-EDGERTON LONGONI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1921 S ALMA SCHOOL RD, 315, MESA, AZ 85210-3036
(480) 755-5553
(480) 456-2964
Mailing address
1921 S ALMA SCHOOL RD, 315, MESA, AZ 85210-3036
(480) 755-5553
(480) 456-2964

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30-0123454
TREE OF LIFE INC
AZ
Enumeration date
03/08/2010
Last updated
04/01/2010
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