Individual
ALISSA J NIEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3565 W 22ND ST UNIT E, YUMA, AZ 85364-7626
(928) 315-3254
Mailing address
3818 W 16TH ST, YUMA, AZ 85364-4107
(928) 317-0177
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
11170207
AZ
385HR2055X
Child Mental Illness Respite Care
11170207
AZ
Other
Enumeration date
08/16/2021
Last updated
08/21/2021
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