Provider Demographics
NPI:1316554678
Name:MIND OVER MATTER MENTAL HEALTH, PLLC
Entity Type:Organization
Organization Name:MIND OVER MATTER MENTAL HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:602-471-0881
Mailing Address - Street 1:4651 E LAVENDER LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-4815
Mailing Address - Country:US
Mailing Address - Phone:602-471-0881
Mailing Address - Fax:480-584-5497
Practice Address - Street 1:11011 S 48TH ST STE 200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-1788
Practice Address - Country:US
Practice Address - Phone:602-471-0881
Practice Address - Fax:480-584-5497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty