Individual
REVA MAE MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4615 NO 82ND LANE, PHOENIX, AZ 85033
(623) 846-1873
(623) 846-1910
Mailing address
4615 NO 82ND LANE, PHOENIX, AZ 85033
(623) 846-1873
(623) 846-1910
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
5333
AZ
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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