institution
Revival Psychiatry And Ketamine Clinic
Psychiatric/Mental Health Nurse Practitioner in Mesa, Arizona
NPI 1235847286

Revival Psychiatry And Ketamine Clinic is a Psychiatric/Mental Health Nurse Practitioner based in Mesa, AZ and is specialized in Psychiatric/Mental Health. Revival Psychiatry And Ketamine Clinic practices in Mesa, AZ. The NPI Number for Revival Psychiatry And Ketamine Clinic is 1235847286 and holds a License No. (Arizona).

The current practice location address for Revival Psychiatry And Ketamine Clinic is 1220 S Alma School Rd Ste 212, Mesa, AZ and can be reached out via phone at 480-613-8162 and via fax at 480-900-8654. You can also correspond with Revival Psychiatry And Ketamine Clinic through the mailing address at 1220 S ALMA SCHOOL RD STE 212, MESA, AZ - 85210-2087 (mailing address contact number: 480-613-8162).

Location: 1220 S Alma School Rd Ste 212, Mesa, AZ, 85210-2087
institution
Provider Profile Details
NPI Number
1235847286
Provider Name
Revival Psychiatry And Ketamine Clinic
Credential
Provider Entity Type
Organization
Address
1220 S Alma School Rd Ste 212, Mesa, AZ, 85210-2087
Phone Number
480-613-8162
Fax Number
480-900-8654
Provider Enumeration Date
11/08/2022
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
1220 S Alma School Rd Ste 212
City
State
Zip
85210-2087
Phone Number
480-613-8162
Fax Number
480-900-8654
person
Provider Business Mailing Address Details
Address
1220 S Alma School Rd Ste 212
City
State
Zip
85210-2087
Phone Number
480-613-8162
Fax Number
480-900-8654
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Multi-Specialty
Taxonomy
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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