| NPI | 1538404991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ALAN WELLEK Owner 602-955-1070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AZ AZ6416) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-0460) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2012-12-11 |