Surette, Iris H

Surette, Iris H is an individual health care provider with primary practice located at 805 E Fremont Tombstone Unified School Dist, Tombstone AZ 85638. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Surette, Iris H can be contacted via phone (520) 456-9842.

Contact Information

Primary practice address
805 E Fremont Tombstone Unified School Dist Tombstone AZ 85638
Fax: (520) 457-3720
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X Arizona

Profile Details

NPI number 1346349149
LBN Legal business name Surette, Iris H
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2006
Last updated Jul 26th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346349149 NPPES
Arizona MEDICAID 620220

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