Healthcare Provider Details

I. General information

NPI: 1831663194
Provider Name (Legal Business Name): RELAXINGONE.COMNEDDAVIDBRATSPISPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2019
Last Update Date: 01/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6625 S RURAL RD STE 111
TEMPE AZ
85283-3717
US

IV. Provider business mailing address

6625 S RURAL RD STE 111
TEMPE AZ
85283-3717
US

V. Phone/Fax

Practice location:
  • Phone: 253-514-0525
  • Fax: 480-345-2126
Mailing address:
  • Phone: 253-514-0525
  • Fax: 480-345-2126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. NED DAVID BRATSPIS
Title or Position: PRESIDENT
Credential: MA, LMFT
Phone: 253-514-0525