Individual
KERRY JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2627 N 45TH AVE APT 2051, PHOENIX, AZ 85035-2321
(602) 245-5724
(520) 407-5398
Mailing address
PO BOX 86537, TUCSON, AZ 85754-6537
(520) 721-1887
(520) 407-5398
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
10424923
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10424923
CHILDRENS THERAPEUTIC FOSTER CARE
AZ
Enumeration date
01/31/2023
Last updated
01/31/2023
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