Organization
EAST VALLEY MENTAL WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN MARIE CASEY PMHNP (MEMBER)
(480) 570-0497
Entity
Organization
Contact information
Practice address
1166 E WARNER RD, SUITE 101, GILBERT, AZ 85296-3064
(480) 570-0497
(480) 452-0145
Mailing address
1166 E WARNER RD, SUITE 101, GILBERT, AZ 85296-3064
(480) 570-0497
(480) 452-0145
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP4476
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
726497
—
AZ
Enumeration date
08/15/2012
Last updated
11/15/2013
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