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Organization
MIKKADESH MENTAL HEALTHCARE LLC
Active
Organization
MIKKADESH MENTAL HEALTHCARE LLC
Active
Other names
Mikkadesh Mental Healthcare LLC
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA ABEH FORCHU (PRESIDENT/ADMINISTRATOR)
(801) 649-7584
Entity
Organization
Contact information
Practice address
12923 EMERALD RIDGE BLVD E, PUYALLUP, WA 98374-8403
(801) 649-7584
Mailing address
12923 EMERALD RIDGE BLVD E, PUYALLUP, WA 98374-8403
(801) 649-7584
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/09/2022
Last updated
12/10/2024
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