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General NPI Number Information
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NPI Number | 1548958010
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Entity Type | Organization
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Legal Business Name | GUIDING LIGHT PSYCHIATRY PLLC
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 4174 LA MESA RD
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City | BULLHEAD CITY
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State | AZ
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Zip | 86429-7755
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Country | US
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Telephone | 928-201-0453
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Fax |
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Provider Business Mailing Address
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Address Line | 1788 HIGHWAY 95 STE 22
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City | BULLHEAD CITY
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State | AZ
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Zip | 86442-6074
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Country | US
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Telephone | 928-404-1390
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NATASHA DEEBES-HOWARD
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Credential |
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Telephone | 928-201-0453
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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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