Individual
WENDY LEDAWN BUMGARNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
297 FORT ROCK ROAD, SELIGMAN, AZ 86337-0213
(928) 925-1884
Mailing address
PO BOX 213, SELIGMAN, AZ 86337-0213
(928) 925-1884
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
1446366
AZ
Other
Enumeration date
06/30/2009
Last updated
06/30/2009
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