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General NPI Number Information
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NPI Number | 1154061513
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Entity Type | Organization
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Legal Business Name | ULTIMATE PROFESSIONAL MENTAL HEALTH SERVICES CORP
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Dates
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Enumeration Date | 03/31/2022
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Last Update Date | 12/14/2022
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Provider Practice Location Address
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Address Line | 748 MARKET ST # 135
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City | TACOMA
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State | WA
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Zip | 98402-3737
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Country | US
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Telephone | 832-819-4378
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Fax | 253-954-3116
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Provider Business Mailing Address
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Address Line | 748 MARKET ST # 135
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City | TACOMA
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State | WA
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Zip | 98402-3737
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Country | US
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Telephone | 832-819-4378
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Fax | 253-954-3116
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Authorized Official
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Title or Position | PMHNP
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Name | ANNABEL OWUSU
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Credential | NURSE PRACTITIONER
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Telephone | 614-804-0866
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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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