Thad Malik
Foster Care Agency in Prescott, AZ. Individual provider (NPI-1).
NPI number1982177689
StatusActive
Last updated in NPPESJan 4, 2019
Details
- NPI
- 1982177689
- Entity type
- Individual (NPI-1)
- Name
- Thad Malik
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 4, 2019
- Last updated
- Jan 4, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253J00000X | Foster Care Agency | 9685638 | AZ | Yes |
Practice location
1708 Sequoia DrPrescott, AZ 86301-1243
Phone 248-825-5715
Mailing address
1708 Sequoia DrPrescott, AZ 86301-1243
Phone 248-825-5715
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