Individual
JUANITA LEE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6924 S 74TH LN, LAVEEN, AZ 85339-5093
(602) 595-6585
Mailing address
6924 S 74TH LN, LAVEEN, AZ 85339-5093
(602) 595-6585
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
5299458
AZ
Other
Enumeration date
06/10/2022
Last updated
06/10/2022
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