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General NPI Number Information
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NPI Number | 1902480767
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Entity Type | Organization
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Legal Business Name | SONAR BEHAVIOR CLINIC INC
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Dates
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Enumeration Date | 05/07/2021
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Last Update Date | 05/07/2021
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Provider Practice Location Address
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Address Line | 250 W 24TH ST STE A
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City | YUMA
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State | AZ
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Zip | 85364-8506
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Country | US
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Telephone | 928-276-4446
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Fax | 928-276-4730
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Provider Business Mailing Address
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Address Line | PO BOX 4175
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City | YUMA
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State | AZ
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Zip | 85366-2413
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Country | US
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Telephone | 928-276-4249
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Fax | 928-276-4730
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Authorized Official
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Title or Position | OWNER
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Name | CHINELO UNOMA UGHANZE
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Credential | PMHNP
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Telephone | 832-287-6096
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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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