NPI 1063535318

Dvonn Annette Ponce, LMTCA

Practitioner Contractor Phoenix, AZ

Practice location

Address: 13832 N 32nd St STE 126, Phoenix, AZ 85032-5616
Phone: (602) 493-2273
Fax: (602) 493-2159

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence #MT-00923P (AZ)

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Registry record

NPI: 1063535318
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Apr 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.