| NPI | 1104362938 |
|---|---|
| Other Name | MATERNAL CHILD SPECIALIST |
| Entity Type | Organization |
| Authorized Contact | NANCY ANN BASKERVILLE Director 602-430-2589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NY 22616900) |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2017-01-18 |