Individual
VANESSA SAMUELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16224 N 154TH DR, SURPRISE, AZ 85374-7416
(602) 283-7117
Mailing address
16224 N 154TH DR, SURPRISE, AZ 85374-7416
(602) 283-7117
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
—
AZ
Other
Enumeration date
07/05/2018
Last updated
07/05/2018
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