| NPI | 1396283933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARISA D BISNICHUK President 520-638-5997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP3414) |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2017-02-02 |