Individual
JAQUELINE LIZARRAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4617 E BELL RD, PHOENIX, AZ 85032-2305
(602) 482-5511
Mailing address
16801 N 31ST ST APT 102, PHOENIX, AZ 85032-2644
(602) 413-9889
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
T067223
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D10948148
PASSPORT
AZ
Enumeration date
04/24/2021
Last updated
04/24/2021
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