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NPI 1982177689

IndividualActive

Thad Malik

NPI 1982177689 · Foster Care Agency · Prescott, AZ

Provider details

NPI number: 1982177689
Entity type: Individual
Primary specialty: Foster Care AgencyAgencies
Sex: Male
Sole proprietor: Yes
License: 9685638 (AZ)

Practice location

1708 Sequoia Dr

Prescott, AZ 86301-1243

Phone: (248) 825-5715

More AZ providers

Mailing address

1708 Sequoia Dr

Prescott, AZ 86301-1243

Registry dates

Enumerated: 2019-01-04
Last updated: 2019-01-04

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Thad Malik — NPI 1982177689, Prescott, AZ | NPI Central