Individual
ISAI VALDEZ LOUCKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3001 N 33RD AVE, PHOENIX, AZ 85017-5202
(602) 353-0703
Mailing address
3001 N 33RD AVE, PHOENIX, AZ 85017-5202
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
0
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
247451
AZ
Other
Enumeration date
03/03/2020
Last updated
06/23/2022
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