Organization · Type 2 NPI

Vitalis Wellness Center of Phoenix, Az PC

Brain Injury Medicine (Psychiatry & Neurology) Physician · Mesa, AZ

NPI number 1497421101 Active

Practice location

1910 S Stapley Dr Ste 120
Mesa, AZ 85204-6676

Specialties and licenses

Taxonomy	Code	License
Brain Injury Medicine (Psychiatry & Neurology) Physician Primary	2084P0301X	None listed
Psychiatry Physician	2084P0800X	None listed
Child & Adolescent Psychiatry Physician	2084P0804X	None listed

Brain Injury Medicine (Psychiatry & Neurology) Physician: A Brain Injury Medicine physician specializes in disorders of brain function due to injury and disease. These disorders encompass a range of medical, physical, neurologic, cognitive, sensory, and behavioral disorders that result in psychosocial, educational, and vocational consequences.

31 other providers at this address

NPI record

NPI: 1497421101
Entity type: Organization (Type 2)
Issued: Aug 22, 2021
Last updated: Jul 19, 2024
Status: Active

Other names

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Vitalis Wellness Center, Az PC · doing business as
Vitalis Wellness Center, Az PC · doing business as

Authorized official

Nellie Idara Samuel, DNP
Co-Owner
(800) 922-1873

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1497421101

Vitalis Wellness Center of Phoenix, Az PC's National Provider Identifier is 1497421101, issued on Aug 22, 2021. The primary taxonomy on file is Brain Injury Medicine (Psychiatry & Neurology) Physician (2084P0301X), and the practice location is in Mesa, AZ. The record was last updated on Jul 19, 2024.