| NPI | 1437682614 |
|---|---|
| Doing Business As | PRESTIGE PSYCHIATRIC PROFESSIONALS |
| Entity Type | Organization |
| Authorized Contact | PAUL ERIC LARRALDE Member 602-910-6519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP5217) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-11647) |
| 101YP2500X Counselor, Professional (Licence: AZ LPC-11774) | |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: AZ RN147893) | |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2017-04-05 |