Individual
TESSA TADDEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 200-5383
Mailing address
1350 E THOMAS RD, 708, PHOENIX, AZ 85014-5703
(610) 848-0491
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
280320
PA
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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