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General NPI Number Information
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NPI Number | 1114790078
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Entity Type | Organization
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Legal Business Name | HAZELWOOD MENTAL HEALTH
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Dates
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Enumeration Date | 11/02/2023
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 7514 E MONTEREY WAY STE 4
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-6900
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Country | US
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Telephone | 480-209-2136
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Fax |
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Provider Business Mailing Address
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Address Line | 7514 E MONTEREY WAY STE 4
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-6900
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, PMHNP
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Name | CHYLLIA DIXON
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Credential | NURSE PRACTITIONER
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Telephone | 809-495-7004
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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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