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1558041632
THERAPEUTIC EDGE LLC
PHOENIX, AZ
NPI
1558041632
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Entity Type
Organization
Authorized Contact
DESTINI MAYFIELD
Owner
623-552-8895
Organization Subpart ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner Psychiatric/Mental Health
Enumeration Date
2023-07-24
Last Update Date
2023-09-13
Business Address
THERAPEUTIC EDGE LLC
3101 N CENTRAL AVE STE 183
PHOENIX, AZ 85012-3616
Phone number: 623-552-8895
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Mailing Address
THERAPEUTIC EDGE LLC
3101 N CENTRAL AVE STE 183
PHOENIX, AZ 85012-3616
Phone number: 623-552-8895
Copy
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