Individual
KELLY FORKASDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
34250 N 60TH ST, SCOTTSDALE, AZ 85266-5201
(480) 596-9622
Mailing address
34250 N 60TH ST, SCOTTSDALE, AZ 85266-5201
(602) 448-1979
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
172V00000X
Community Health Worker
—
—
174H00000X
Health Educator
—
AZ
Other
Enumeration date
09/25/2023
Last updated
03/18/2024
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