Individual
ELEASE KATHRYN TEWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4411 N 99TH AVE UNIT 3073, PHOENIX, AZ 85037-1381
(480) 772-3402
Mailing address
4411 N 99TH AVE UNIT 3073, PHOENIX, AZ 85037-1381
(480) 772-3402
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
AZ
Other
Enumeration date
05/13/2026
Last updated
05/13/2026
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