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General NPI Number Information
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NPI Number | 1104445394
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Entity Type | Organization
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Legal Business Name | UNIVERSAL PSYCHIATRY LLC
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Dates
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Enumeration Date | 04/09/2020
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 18 HOLSTON HILLS RD
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City | HENDERSON
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State | NV
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Zip | 89052-6642
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Country | US
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Telephone | 34-760-4416
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Fax | 702-852-0459
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Provider Business Mailing Address
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Address Line | 18 HOLSTON HILLS RD
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City | HENDERSON
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State | NV
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Zip | 89052-6642
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Country | US
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Telephone | 34-760-4416
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MAGDALENA MALLOY
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Credential | APRN
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Telephone | 919-257-0067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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