# PRACTICERX

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063223774
- **Authorized official:** CLAYTON HALL (OWNER)
- **Authorized official phone:** (480) 290-2487

## Contact information

- **Practice address:** 15170 N HAYDEN RD STE 6B, SCOTTSDALE, AZ 85260-2571
- **Practice address phone:** (480) 290-2487
- **Mailing address:** 15170 N HAYDEN RD STE 6B, SCOTTSDALE, AZ 85260-2571
- **Mailing address phone:** (480) 290-2487

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/14/2025
- **Last updated:** 01/14/2025