Healthcare Provider Details

I. General information

NPI: 1912706169
Provider Name (Legal Business Name): WEINRICH HEALTH & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 12TH PL STE 13
PRESCOTT AZ
86305-1433
US

IV. Provider business mailing address

2810 HARRISON DR
CHINO VALLEY AZ
86323-5549
US

V. Phone/Fax

Practice location:
  • Phone: 928-533-6805
  • Fax:
Mailing address:
  • Phone: 928-533-6805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE WEINRICH
Title or Position: FNP-C, PMHNP-BC
Credential:
Phone: 928-533-6805