Organization · Type 2 NPI
Fourth Wall Wellness LLC
Psychiatric/Mental Health Nurse Practitioner · Tucson, AZ
NPI number
1124869581
Active
Practice location
6137 E Grant Rd
Tucson, AZ 85712-5829
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | None listed |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
2 other providers at this address
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About NPI 1124869581
Fourth Wall Wellness LLC's National Provider Identifier is 1124869581, issued on Jun 1, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Tucson, AZ. The record was last updated on Feb 24, 2025.