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General NPI Number Information
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NPI Number | 1326643032
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Entity Type | Organization
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Legal Business Name | TELEHEALTH ON THE GO
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 01/26/2021
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Provider Practice Location Address
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Address Line | 3104 E CAMELBACK RD
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City | PHOENIX
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State | AZ
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Zip | 85016-4502
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Country | US
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Telephone | 602-699-5753
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Fax |
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Provider Business Mailing Address
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Address Line | 3104 E CAMELBACK RD
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City | PHOENIX
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State | AZ
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Zip | 85016-4502
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Country | US
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Telephone | 602-699-5753
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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 | BRIANNE TERRELL
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Credential | PMHNP
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Telephone | 602-699-5753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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