Graduated: 2016
NPI: 1730543968
Practice Locations (3)
DHEW IND HLTH SV HLTH SVS AND MNTL HLTH ADM
4212 N 16TH ST
PHOENIX, AZ 850165319
6022631200
DHHS IHS PHOENIX AREA
200 W HOSPITAL DR
WHITERIVER, AZ 859410860
92833849113532
DHHS IHS PHOENIX AREA
PO BOX, SUITE 860
WHITERIVER, AZ 859410860
Source: CMS National Downloadable File, September 2026.