Individual
ABRA ELLISA DALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FOSTER CARE
Contact information
Practice address
44768 W HORSE MESA RD, MARICOPA, AZ 85139-9124
(520) 280-6866
Mailing address
44768 W HORSE MESA RD, MARICOPA, AZ 85139-9124
(520) 280-6866
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
Other
Enumeration date
03/20/2013
Last updated
03/20/2013
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