IDEAL SELF LLC

PHOENIX, AZ
NPI1467182774
Entity TypeOrganization
Authorized ContactANGELA CHILDS
Owner/Provider
623-303-6777
Organization Subpart ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
Additional Taxonomies363LF0000X Nurse Practitioner, Family
Enumeration Date2022-06-10
Last Update Date2023-03-19
Business Address
IDEAL SELF LLC
12620 N CAVE CREEK RD STE 10A
PHOENIX, AZ 85022-6528
Phone number: 623-303-6777
Mailing Address
IDEAL SELF LLC
12620 N CAVE CREEK RD STE 10A
PHOENIX, AZ 85022-6528
Phone number: 623-303-6777