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General NPI Number Information
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NPI Number | 1356749543
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Entity Type | Organization
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Legal Business Name | NOTRE DAME BEHAVIORAL HEALTH, PLLC
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Dates
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Enumeration Date | 12/21/2014
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | 14811 W BELL RD STE 100
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City | SURPRISE
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State | AZ
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Zip | 85374-7602
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Country | US
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Telephone | 623-328-7323
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Fax | 623-337-4917
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Provider Business Mailing Address
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Address Line | 14811 W BELL RD STE 100
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City | SURPRISE
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State | AZ
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Zip | 85374-7602
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Country | US
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Telephone | 623-328-7323
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Fax | 623-337-4917
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | HANY S. ASHAMALLA
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Credential | MD
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Telephone | 623-328-7323
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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 | 45901
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License Number State | AZ
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