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Organization
DIVINE WELLNESS PSYCHIATRIC SERVICES PLLC
Active
Organization
DIVINE WELLNESS PSYCHIATRIC SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IHEANYI AMANWANNE (OWNER)
(602) 465-6011
Entity
Organization
Contact information
Practice address
3101 N CENTRAL AVE STE 183, PHOENIX, AZ 85012-3616
(602) 465-6011
Mailing address
3880 W RANIER CT STE 183, ANTHEM, AZ 85086-8018
(602) 465-6011
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
12/08/2023
Last updated
12/08/2023
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