Provider Demographics
NPI:1083462378
Name:ULTIMATE PSYCHIATRY PLLC
Entity type:Organization
Organization Name:ULTIMATE PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OWUSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-819-4378
Mailing Address - Street 1:4257 S SOBOBA ST
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-8263
Mailing Address - Country:US
Mailing Address - Phone:832-819-4378
Mailing Address - Fax:253-954-3116
Practice Address - Street 1:1155 S POWER RD STE 114
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-3716
Practice Address - Country:US
Practice Address - Phone:832-819-4378
Practice Address - Fax:253-954-3116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty