Immanuel Behavioral Health Counseling Clinic

NPI #1104495084 in Peoria, Arizona

Provider Information

NPI Number: 1104495084
Entity Type: Organization
Organization Name: Immanuel Behavioral Health Counseling Clinic
Subpart: Yes (part of a larger organization)
Parent Organization: 15856
Primary Specialty: Clinic/Center
Enumeration Date: Jun 23, 2021
Last Updated: Apr 27, 2023

Practice Location

Address: 11301 N 99TH AVE STE 5120
City: Peoria
State: Arizona
ZIP Code: 85345-5485
Phone: (623) 876-6379

Authorized Official

Name: BRENDA KAY PIERCE, MD MA
Title: CHIEF OPERATING OFFICER
Phone: (623) 738-8549

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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