| NPI | 1053182204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA KACZMAREK Owner/Provider 480-904-8671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2024-12-11 |