| NPI | 1811684731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIDONIE B NGANKEU Owner/Provider 928-770-2053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-04-20 |
| Last Update Date | 2026-06-24 |