Organization · Type 2 NPI
Ideal Self LLC
Psychiatric/Mental Health Nurse Practitioner · Phoenix, AZ
NPI number
1467182774
Active
Practice location
12620 N Cave Creek Rd Ste 10A
Phoenix, AZ 85022-6528
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | None listed |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1467182774
Ideal Self LLC's National Provider Identifier is 1467182774, issued on Jun 10, 2022. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Phoenix, AZ. The record was last updated on Mar 19, 2023.