Organization
IMANI MENTAL HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN N MBUGUA PMHNP-BC (MENTAL HEALTH NURSE PRACTITIONER)
(214) 458-1713
Entity
Organization
Contact information
Practice address
3939 NE HANCOCK ST # 202, PORTLAND, OR 97212-5321
(214) 458-1713
Mailing address
12063 SW TAYLOR CT, PORTLAND, OR 97225-5845
(214) 458-1713
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/12/2021
Last updated
01/25/2021
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