Individual provider · NPI-1

Dale Philip Ferguson

Respite Care, Respite Care, Mental Illness, Child · Peoria, AZ

NPI number1790844322
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1790844322
Entity type
Individual (NPI-1)
Name
Mr. Dale Philip Ferguson
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 8, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
385HR2055X Respite Care, Respite Care, Mental Illness, Child11264AZYes

Practice location

8770 W Paradise Dr
Peoria, AZ 85345

Phone 623-486-8307

Mailing address

8770 W Paradise Dr
Peoria, AZ 85345

Phone 623-486-8307

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