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General NPI Number Information
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NPI Number | 1942000955
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Entity Type | Organization
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Legal Business Name | MARCANN HEALTH ALLIANCE
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 13925 W MEEKER BLVD STE 18
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City | SUN CITY
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State | AZ
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Zip | 85375-4432
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Country | US
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Telephone | 602-824-9309
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Fax |
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Provider Business Mailing Address
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Address Line | 13925 W MEEKER BLVD STE 18
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City | SUN CITY
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State | AZ
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Zip | 85375-4432
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Country | US
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Telephone | 602-824-9309
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | STEVEN DOMANN
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Credential | PSY.D
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Telephone | 602-824-9309
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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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