Organization
EQUINE EDUCATIONAL EXPERIENCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA JO HALTERMAN M.ED. (PRESIDENT)
(928) 606-6007
Entity
Organization
Contact information
Practice address
7795 PINE CANYON DR, FLAGSTAFF, AZ 86004-1266
(928) 606-6007
Mailing address
7795 PINE CANYON DR, FLAGSTAFF, AZ 86004-1266
(928) 606-6007
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LAC 12862
AZ
Other
Enumeration date
02/16/2011
Last updated
02/16/2011
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