| Wanderist Behavioral Health Pllc | |
|
2600 E Southern Ave Ste C3 Tempe AZ 85282-7609 | |
| (626) 515-8875 | |
| Not Available |
| Full Name | Wanderist Behavioral Health Pllc |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 2600 E Southern Ave Ste C3, Tempe, Arizona |
| Authorized Official Name and Position | Nicole Carlson (PSYCHIATRIC NURSE PRACTITIONER) |
| Authorized Official Contact | 6265158875 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wanderist Behavioral Health Pllc 2600 E Southern Ave Ste C3 Tempe AZ 85282-7609 Ph: (626) 515-8875 | Wanderist Behavioral Health Pllc 2600 E Southern Ave Ste C3 Tempe AZ 85282-7609 Ph: (626) 515-8875 |
| NPI Number | 1295559441 |
|---|---|
| Provider Enumeration Date | 11/14/2024 |
| Last Update Date | 11/14/2024 |
| Certification Date | 11/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295559441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
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