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General NPI Number Information
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NPI Number | 1316324353
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Entity Type | Individual
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Provider Name | BRENDA TAFOYA
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Gender | Female
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Dates
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Enumeration Date | 04/28/2015
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Last Update Date | 04/28/2015
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Provider Practice Location Address
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Address Line | 9130 N 94TH AVE
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City | PEORIA
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State | AZ
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Zip | 85345-6341
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Country | US
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Telephone | 623-251-6590
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Fax |
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Provider Business Mailing Address
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Address Line | 711 E MISSOURI AVE STE 300
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City | PHOENIX
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State | AZ
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Zip | 85014-2841
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 5296315
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License Number State | AZ
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