Organization
MAPO WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HORTENSE BISSILA PMHNP (OWNER)
(901) 800-1037
Entity
Organization
Contact information
Practice address
4494 W PEORIA AVE STE 13-115A, GLENDALE, AZ 85302-2023
(901) 800-1037
Mailing address
8225 ROCKCREEK PKWY, CORDOVA, TN 38016-4594
(901) 800-1037
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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