Individual
SVETIANA MIJALSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9326 W LOUISE DR, PEORIA, AZ 85383-2960
(602) 290-3584
Mailing address
17313 N 19TH TER, PHOENIX, AZ 85022-8100
(602) 290-3584
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
AL114G1H
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123456789
—
AZ
Enumeration date
05/24/2021
Last updated
05/24/2021
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