NPI | 1447864202 |
---|---|
Entity Type | Organization |
Authorized Contact | RICHARD WADE Dnp/Authorized Official 480-550-7460 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
Enumeration Date | 2020-08-31 |
Last Update Date | 2020-08-31 |