Individual
KAREN LAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4013 E PUEBLO AVE, MESA, AZ 85206-5122
(480) 694-9002
Mailing address
4013 E PUEBLO AVE, MESA, AZ 85206-5122
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
BH5561
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH5561
AZ DEPT OF HEALTH SERVICES
AZ
Enumeration date
11/02/2018
Last updated
11/02/2018
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