Provider Demographics
NPI:1801645007
Name:IYALI MENTAL WELLNESS LLC
Entity type:Organization
Organization Name:IYALI MENTAL WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRINCESS
Authorized Official - Middle Name:
Authorized Official - Last Name:DARKO-AMOAKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-294-9495
Mailing Address - Street 1:1255 W BASELINE RD STE B-139
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-5820
Mailing Address - Country:US
Mailing Address - Phone:623-294-9495
Mailing Address - Fax:623-401-6199
Practice Address - Street 1:1255 W BASELINE RD STE B-139
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-5820
Practice Address - Country:US
Practice Address - Phone:623-294-9495
Practice Address - Fax:623-401-6199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-18
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty