Provider Demographics
NPI:1720870157
Name:SYMPHONY PSYCHIATRIC PLLC
Entity type:Organization
Organization Name:SYMPHONY PSYCHIATRIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:GOUNI
Authorized Official - Middle Name:AICHA
Authorized Official - Last Name:BOURAIMA
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, PMH-BC
Authorized Official - Phone:520-551-6765
Mailing Address - Street 1:11269 W FOLSOM POINT DR
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85658-4998
Mailing Address - Country:US
Mailing Address - Phone:520-551-6765
Mailing Address - Fax:
Practice Address - Street 1:11269 W FOLSOM POINT DR
Practice Address - Street 2:
Practice Address - City:MARANA
Practice Address - State:AZ
Practice Address - Zip Code:85658-4998
Practice Address - Country:US
Practice Address - Phone:520-551-6765
Practice Address - Fax:520-551-6765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty