Sophie Gastelum
Home Health Aide in Queen Creek, AZ. Individual provider (NPI-1).
NPI number1366090102
StatusActive
Last updated in NPPESAug 26, 2019
Details
- NPI
- 1366090102
- Entity type
- Individual (NPI-1)
- Name
- Sophie Gastelum
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 26, 2019
- Last updated
- Aug 26, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374U00000X | Home Health Aide | 230136 | AZ | Yes |
Practice location
20521 E Canary CtQueen Creek, AZ 85142-3406
Phone 208-420-6678
Mailing address
484 W Toledo StChandler, AZ 85225-4510
Phone 480-306-3827
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