| NPI | 1598307969 |
|---|---|
| Doing Business As | PHOENIX MENTAL WELLNESS GROUP |
| Entity Type | Organization |
| Authorized Contact | EDWARD KRAGER Owner 209-271-3595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2019-10-17 |