Individual
LISA LAFAYE LARRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1720 E THUNDERBIRD RD, APT 2024, PHOENIX, AZ 85022-5770
(480) 593-7833
Mailing address
1720 E THUNDERBIRD RD, APT 2024, PHOENIX, AZ 85022-5770
(480) 593-7833
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
449603
AZ
Other
Enumeration date
02/19/2010
Last updated
02/19/2010
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