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General NPI Number Information
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NPI Number | 1326828625
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Entity Type | Organization
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Legal Business Name | WHITE PEAK PSYCHIATRY
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Dates
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Enumeration Date | 10/03/2023
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Last Update Date | 10/03/2023
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Provider Practice Location Address
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Address Line | 13184 W WOODSTOCK RD
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City | PEORIA
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State | AZ
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Zip | 85383-6072
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Country | US
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Telephone | 25-609-9256
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Fax | 602-838-4392
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Provider Business Mailing Address
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Address Line | 13184 W WOODSTOCK RD
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City | PEORIA
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State | AZ
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Zip | 85383-6072
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Country | US
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Telephone | 623-521-7253
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Fax |
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Authorized Official
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Title or Position | PMHNP-BC
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Name | VANESSA MOE
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Credential | DNP
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Telephone | 602-560-9925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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