Doctor Name: | TERESA BLOCK |
NPI Number: | 1023021912 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | RN-097883 |
Business Practice Address: | 2187 N Vickey St Flagstaff, AZ - 860046106 |
Business Phone Number: | 9287146401 |
Business Fax Number: | 9287146480 |
Mailing Address: | 2187 N Vickey St, FLAGSTAFF |
State: | AZ |
Postal Code: | 860046106 |
Phone Number: | 9287146401 |
Fax Number: | 9287146480 |
NPI Enumeration Date: | 08/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | RN-097883 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |