| NPI | 1841062577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER CHRISTINE FENDLER Nurse Practitioner 602-370-5195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QM0801X | |
| Enumeration Date | 2023-10-25 |
| Last Update Date | 2023-11-27 |