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General NPI Number Information
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NPI Number | 1831718915
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Entity Type | Organization
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Legal Business Name | AGAVE PSYCHIATRY PLLC
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Dates
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Enumeration Date | 04/09/2020
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 20118 N 67TH AVE STE 300-609
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City | GLENDALE
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State | AZ
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Zip | 85308-4621
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Country | US
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Telephone | 602-857-8182
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Fax | 602-585-0788
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Provider Business Mailing Address
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Address Line | 20118 N 67TH AVE STE 300-609
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City | GLENDALE
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State | AZ
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Zip | 85308-4621
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Country | US
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Telephone | 602-857-8182
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Fax | 602-585-0788
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Authorized Official
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Title or Position | MEMBER
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Name | DR. AARON KRAMER
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Credential | DO
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Telephone | 602-857-8182
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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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