Healthcare Provider Details

I. General information

NPI: 1154266773
Provider Name (Legal Business Name): HOZHO WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 YUCCA PLANT TRL
DILKON AZ
86047
US

IV. Provider business mailing address

HC 63 BOX 6267
WINSLOW AZ
86047
US

V. Phone/Fax

Practice location:
  • Phone: 928-310-6414
  • Fax:
Mailing address:
  • Phone: 928-310-6414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: JULIE MALONEY
Title or Position: PHYSICIAN ASSISTANT
Credential: PA
Phone: 928-310-6414