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General NPI Number Information
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NPI Number | 1427434695
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Entity Type | Organization
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Legal Business Name | MOODCLINICS LLC
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | 7828 N 19TH AVE STE 10
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City | PHOENIX
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State | AZ
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Zip | 85021-7044
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Country | US
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Telephone | 602-923-0436
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Fax | 480-566-0247
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Provider Business Mailing Address
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Address Line | 7828 N 19TH AVE STE 10
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City | PHOENIX
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State | AZ
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Zip | 85021-7044
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Country | US
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Telephone | 480-567-0225
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Fax | 480-566-0247
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Authorized Official
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Title or Position | OWNER/SOLE PROVIDER
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Name | HUGHES MOHLIE
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Credential | ANP
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Telephone | 602-923-0436
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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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