Naomi Konkel

Individual provider Active NPI Child Mental Illness Respite Care · Williams, AZ

NPI 1154739654 · NPPES record last updated Jul 28, 2014

Key facts

NPI
1154739654
Entity type
Individual (NPI type 1)
Primary specialty
Child Mental Illness Respite Care 385HR2055X
License
5945516 (AZ)
Practice address
818 Quarter Horse Rd
Williams, AZ 86046-9643
Phone
(928) 380-4360
NPI assigned
Jul 28, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5945516AZMDChild Mental Illness Respite Care

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Child Mental Illness Respite Care 385HR2055X 5945516 AZ Yes

Addresses

Primary practice location

818 Quarter Horse Rd
Williams, AZ 86046-9643

Mailing address

818 Quarter Horse Rd
Williams, AZ 86046-9643
Phone (928) 380-4360

Other providers in Williams, AZ

All providers in Williams, AZ · Child Mental Illness Respite Care in Arizona

Sources for this page

Verify at the official NPI Registry.