| NPI | 1922718055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM FOX Dnp 623-377-0825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-11-30 |
| Last Update Date | 2022-11-30 |