Organization
HEALTH AND WELLNESS PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE DECKER (CREDENTIALING MANAGER)
(480) 269-2971
Entity
Organization
Contact information
Practice address
4001 E BASELINE RD STE 204, GILBERT, AZ 85234-2743
(480) 565-6440
(480) 452-0691
Mailing address
70 S VAL VISTA DR STE A3-659, GILBERT, AZ 85296-1374
(480) 269-2971
(480) 452-0691
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/04/2020
Last updated
12/04/2020
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