Individual
HANNAH WOTASIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1374 S BURLINGTON ST, FLAGSTAFF, AZ 86001-2445
(928) 310-8228
Mailing address
1374 S BURLINGTON ST, FLAGSTAFF, AZ 86001-2445
(928) 310-8228
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
5418731
AZ
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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