Individual
ELIZABETH ANN MANNEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1225 W PANORAMA RD, TUCSON, AZ 85704-2834
(520) 235-8262
Mailing address
1225 W PANORAMA RD, TUCSON, AZ 85704-2834
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
BH6043
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH6043
AZ DEPT OF HEALTH SERVICES
AZ
Enumeration date
02/07/2020
Last updated
02/07/2020
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