| NPI | 1104929504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY SIMON Authorized Official 602-307-5330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 103TC1900X Psychologist, Counseling | |
| 251K00000X Public Health or Welfare | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2024-10-25 |