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KELLIE L CARDOZA BHT
>> Day Training/Habilitation Specialist >> Nursing Service Related ProvidersRegistrant NPI Number: 1669072161
Individual Registrant: KELLIE L CARDOZA BHT
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
6148 W FRIER DR GLENDALE, AZ 85301-1223 US
Tel: 315-955-0170 Fax: --
Tel: 315-955-0170 Fax: --
Contact information for business:
6148 W FRIER DR GLENDALE, AZ 85301-1223 US
Tel: 315-955-0170 Fax: --
Tel: 315-955-0170 Fax: --
Registration Information:
NPI: 1669072161
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 373H00000X | Nursing Service Related Providers Day Training/Habilitation Specialist |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 7777777 | AZ | 05 |
