Individual
LONNIE L BELLAMY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18611 E SWAN DR, QUEEN CREEK, AZ 85242-5148
(602) 740-6343
Mailing address
18611 E SWAN DR, QUEEN CREEK, AZ 85242-5148
(602) 740-6343
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
9857
AZ
Other
Enumeration date
10/15/2008
Last updated
10/15/2008
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