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1548012966
PONDEROSA PSYCHIATRY PLLC
PHOENIX, AZ
NPI
1548012966
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Entity Type
Organization
Authorized Contact
CAMEO E JOHNSON
Owner
928-235-2927
Organization Subpart ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
Enumeration Date
2024-04-02
Last Update Date
2024-04-04
Business Address
PONDEROSA PSYCHIATRY PLLC
2030 W BASELINE RD # 182-8355
PHOENIX, AZ 85041-6574
Phone number: 928-235-2927
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Mailing Address
PONDEROSA PSYCHIATRY PLLC
2030 W BASELINE RD # 182-8355
PHOENIX, AZ 85041-6574
Phone number: 928-235-2927
Copy
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