Organization
GENTLE BEHAVIORAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANA PETERSON PMHNP (OWNER)
(480) 307-8809
Entity
Organization
Contact information
Practice address
1041 S LEBARON STE P, MESA, AZ 85210-3630
(480) 307-8809
(888) 972-7050
Mailing address
1041 S LEBARON STE P, MESA, AZ 85210-3630
(480) 307-8809
(888) 972-7050
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
787757
—
AZ
Enumeration date
10/11/2018
Last updated
10/12/2018
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