| NPI | 1114590072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER WEATHERFORD Owner 480-322-1415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2022-01-11 |