| NPI | 1033702519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FIDELIS OSONDU EBEREONWU Director 480-332-8764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2021-08-27 |