NPI 1407396450

Mikala Edwards, CTRS

Practitioner Prevention Professional Phoenix, AZ

Practice location

Address: 20806 N 31st Ave, Phoenix, AZ 85027-1729
Phone: (602) 576-4344

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence 59414 (AZ)

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Registry record

NPI: 1407396450
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 Feb 2017
Record last updated: 23 Feb 2017

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.