| NPI | 1215792338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS CONRAD EISEMANN-ASTONE Np/Owner 480-913-5872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2025-01-11 |