| NPI | 1366211971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER JANE PETERSON Chief Executive Officer 623-205-3505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-12-22 |
| Last Update Date | 2024-03-27 |