Provider Demographics
NPI:1508361999
Name:MINDFUL CHOICE INSTITUTE PLLC
Entity Type:Organization
Organization Name:MINDFUL CHOICE INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC MENTAL HEALTH NP
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTZLER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:520-477-1180
Mailing Address - Street 1:17470 N PACESETTER WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5445
Mailing Address - Country:US
Mailing Address - Phone:520-477-1180
Mailing Address - Fax:440-337-8178
Practice Address - Street 1:1384 E WALKER SPRINGS PL
Practice Address - Street 2:
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85629-6609
Practice Address - Country:US
Practice Address - Phone:520-477-1180
Practice Address - Fax:440-337-8178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-27
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP02442363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty