Individual
VIRGINIA MWAURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3101 N 64TH ST, MESA, AZ 85215-0927
(602) 300-5221
Mailing address
3101 N 64TH ST, MESA, AZ 85215-0927
(602) 300-5221
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
BH4913
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH4913
ARIZONA DEPT OF HEALTH SERVICES
AZ
Enumeration date
12/07/2016
Last updated
12/07/2016
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