Individual
SAMANTHA SHOLEH WILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
2311 W ROYAL PALM RD, PHOENIX, AZ 85021-4916
(602) 353-2340
Mailing address
7770 N PLACITA SIN MENTIRAS, TUCSON, AZ 85718-1286
(503) 334-6481
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
225016
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
553996
—
AZ
Enumeration date
04/19/2019
Last updated
07/30/2019
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