Healthcare Provider Details

I. General information

NPI: 1407779333
Provider Name (Legal Business Name): AZ MOOD AND MIND PSYCHIATRIC CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

698 E WETMORE RD STE 370
TUCSON AZ
85705-1773
US

IV. Provider business mailing address

698 E WETMORE RD STE 370
TUCSON AZ
85705-1773
US

V. Phone/Fax

Practice location:
  • Phone: 520-300-6131
  • Fax:
Mailing address:
  • Phone: 520-300-6131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. AHMAD TAYLOR
Title or Position: PHYSICIAN ASSISTANT
Credential: MHS
Phone: 520-300-6131