| NPI | 1851754105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA ANN HICKMAN Owner 602-441-2778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ AP5445) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2020-10-05 |