Willis, Kathy Renee
Willis, Kathy Renee is an sole proprietor health care provider with primary practice located at 11026 E Segura Ave , Mesa AZ 85212-5214. She recently has 2 registered licenses in different health care specialties including Respite Care Facility / Respite Care, Mental Illness, Child, Behavioral Health & Social Service Providers / Social Worker. Respite Care Facility / Respite Care, Mental Illness, Child is her primary health care specialty. Willis, Kathy Renee can be contacted via phone (480) 235-9107.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Respite Care Facility / Respite Care, Mental Illness, Child | 385HR2055X | 3162012 | Arizona |
Behavioral Health & Social Service Providers / Social Worker | 104100000X | 3162012 | Arizona |
Profile Details
NPI number | 1932476611 |
---|---|
LBN Legal business name | Willis, Kathy Renee |
Credentials | |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Nov 22nd, 2011 |
Last updated | Aug 17th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1932476611 | NPPES |
Arizona | Other | 3162012 | AZ DEPT OF HEALTH SERVICES |
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