Individual
DAISY MENJIVAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19918 N 65TH AVE, GLENDALE, AZ 85308-7088
(480) 806-9877
Mailing address
19918 N 65TH AVE, GLENDALE, AZ 85308-7088
(480) 806-9877
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
AL10812H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
881159309
—
AZ
Enumeration date
04/05/2022
Last updated
04/05/2022
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