Amy Larissa Dedea, PHARMD, PA-C

NPI #1861506370 in Dewey, Arizona

Provider Information

NPI Number: 1861506370
Entity Type: Individual
Name: Amy Larissa Dedea, PHARMD, PA-C
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PHARMD, PA-C
Enumeration Date: Aug 19, 2006
Last Updated: Sep 18, 2019

Practice Location

Address: 12075 AZ-69
City: Dewey
State: Arizona
ZIP Code: 86327
Phone: (928) 772-1673

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X
Physician Assistant	363A00000X	Primary

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