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NPI 1124771597

NPI 1124771597 : PSYCHIATRIC REMEDY PLLC : NEW RIVER, AZ

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General NPI Number Information
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    NPI Number           |    1124771597
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    Entity Type          |    Organization 
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    Legal Business Name  |    PSYCHIATRIC REMEDY PLLC 
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Dates
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    Enumeration Date     |    01/27/2022
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    Last Update Date     |    01/27/2022
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Provider Practice Location Address
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    Address Line         |    4310 W PHALEN DR 
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    City                 |    NEW RIVER
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    State                |    AZ
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    Zip                  |    85087-5986
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    Country              |    US
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    Telephone            |    602-718-7637
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4310 W PHALEN DR 
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    City                 |    NEW RIVER
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    State                |    AZ
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    Zip                  |    85087-5986
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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    |    PSYCHIATRIC NURSE PRACTITIONER
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    Name                 |    MR. ENGELBERT  MARRERO 
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    Credential           |    PMHNP-BC
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    Telephone            |    602-718-7637
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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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