| NPI | 1831855683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN DY Nurse Practitioner 480-280-8690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2024-04-01 |