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Organization
EQUITY BEHAVIORAL HEALTH, LLC
Active
Organization
EQUITY BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARILYN ANN STAIRES PMHNP-BC (PROVIDER, OWNER)
(401) 480-5544
Entity
Organization
Contact information
Practice address
334 W 10TH PL STE 104, MESA, AZ 85201-3499
(401) 480-5544
Mailing address
334 W 10TH PL STE 104, MESA, AZ 85201-3499
(401) 480-5544
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962724799
—
AZ
Enumeration date
03/01/2022
Last updated
03/03/2022
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