| NPI | 1346899440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARL B WICK Owner Manager 602-633-5563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |