| NPI | 1376212860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY PROFFITT Director Of Billing 480-219-7178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC0700X Psychologist, Clinical | |
| 104100000X Social Worker | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult | |
| 164W00000X Licensed Practical Nurse | |
| 363A00000X Physician Assistant | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2023-08-11 |