Individual
MATILDA OTANG EYONG EPSE EBAIETAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
3755 S ROME STREET, GILBERT, AZ 85297
(480) 677-5500
Mailing address
6945 S OPAL DR, CHANDLER, AZ 85249-7221
(480) 452-6424
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
223835
AZ
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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