Doctor Name: | BETTY RAE GARIBALDI |
NPI Number: | 1104103746 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPN |
License Number: | LP15879 |
Business Practice Address: | 2920 N 34th Dr Phoenix, AZ - 850175250 |
Business Phone Number: | 6027640834 |
Business Fax Number: | 6022712963 |
Mailing Address: | 4502 N Central Ave, PHOENIX |
State: | AZ |
Postal Code: | 850121817 |
Phone Number: | 6027640834 |
Fax Number: | 6022712963 |
NPI Enumeration Date: | 11/10/2011 |
NPI Last Update Date: | 11/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | LP15879 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |