NPI | 1356889711 |
---|---|
Former Legal Business Name | VERDE VALLEY GUIDANCE CLINIC |
Entity Type | Organization |
Authorized Contact | CORINNE BAILEY Credentilaing Specialist 928-634-2236 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 208000000X Pediatrics |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2017-02-06 |
Last Update Date | 2020-03-09 |