Healthcare Provider Details

I. General information

NPI: 1174129332
Provider Name (Legal Business Name): PAPERFLOWER PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2020
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W BASELINE RD STE 108
TEMPE AZ
85283-5349
US

IV. Provider business mailing address

3104 E CAMELBACK RD # 2414
PHOENIX AZ
85016-4502
US

V. Phone/Fax

Practice location:
  • Phone: 928-504-4700
  • Fax:
Mailing address:
  • Phone: 928-504-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARIA THERESA INGALLA
Title or Position: OWNER
Credential: NP
Phone: 928-504-4700