Individual
DORIS TIH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
12034 W POLK ST, AVONDALE, AZ 85323-7202
(310) 940-2265
Mailing address
PO BOX 127, LITCHFIELD PARK, AZ 85340-0127
(310) 940-2265
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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