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General NPI Number Information
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NPI Number | 1982372488
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Entity Type | Organization
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Legal Business Name | SPECTRUM OF VIBES, LLC
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Dates
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Enumeration Date | 08/31/2021
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 64 E BROADWAY RD STE 200
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City | TEMPE
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State | AZ
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Zip | 85282-1377
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Country | US
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Telephone | 480-372-4135
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Fax | 602-671-6997
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Provider Business Mailing Address
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Address Line | PO BOX 11433
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City | CHANDLER
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State | AZ
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Zip | 85248-0008
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Country | US
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Telephone | 602-910-0357
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Fax | 602-671-6997
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MS. MEAZA G EJIGU
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Credential | NP
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Telephone | 623-680-5243
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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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