| NPI | 1023432465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY EVANS Partner 480-510-1599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP5146) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2023-04-19 |