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General NPI Number Information
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NPI Number | 1720870157
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Entity Type | Organization
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Legal Business Name | SYMPHONY PSYCHIATRIC PLLC
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Dates
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Enumeration Date | 05/21/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 11269 W FOLSOM POINT DR
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City | MARANA
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State | AZ
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Zip | 85658-4998
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Country | US
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Telephone | 520-551-6765
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Fax | 520-551-6765
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Provider Business Mailing Address
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Address Line | 11269 W FOLSOM POINT DR
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City | MARANA
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State | AZ
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Zip | 85658-4998
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Country | US
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Telephone | 520-551-6765
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | GOUNI AICHA BOURAIMA
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Credential | MSN, APRN, PMH-BC
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Telephone | 520-551-6765
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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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