| Roxanne R Domek, Pllc | |
|
3707 E Southern Ave Ste 1066 Mesa AZ 85206-6206 | |
| (480) 823-0360 | |
| Not Available |
| Full Name | Roxanne R Domek, Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 3707 E Southern Ave Ste 1066, Mesa, Arizona |
| Authorized Official Name and Position | Roxanne R Domek (OWNER) |
| Authorized Official Contact | 4808230360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roxanne R Domek, Pllc 3707 E Southern Ave Ste 1066 Mesa AZ 85206-6206 Ph: (480) 823-0360 | Roxanne R Domek, Pllc 3707 E Southern Ave Ste 1066 Mesa AZ 85206-6206 Ph: (480) 823-0360 |
| NPI Number | 1982356077 |
|---|---|
| Provider Enumeration Date | 01/20/2022 |
| Last Update Date | 01/20/2022 |
| Certification Date | 01/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982356077 | NPI | - | NPPES |
| 1790819027 | Other | ND | TYPE I NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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