Provider Demographics
NPI:1679636781
Name:DOSS, GRETA DENISE
Entity Type:Individual
Prefix:
First Name:GRETA
Middle Name:DENISE
Last Name:DOSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 S 102 LN
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353
Mailing Address - Country:US
Mailing Address - Phone:623-204-8760
Mailing Address - Fax:
Practice Address - Street 1:3006 S 102 LN
Practice Address - Street 2:
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353
Practice Address - Country:US
Practice Address - Phone:623-204-8760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child