| NPI | 1285823377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROXANNE DALTOS Pres. 480-641-1165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: AZ OTC6153) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2020-05-27 |