Basic Information
Provider Information
NPI: 1417510405
EntityType: 2
ReplacementNPI:  
OrganizationName: APPLIED BEHAVIORAL INTERVENTIONS PLLC
LastName:  
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Mailing Information
Address1: 10000 N 31ST AVE
Address2: A107
City: PHOENIX
State: AZ
PostalCode: 85051
CountryCode: US
TelephoneNumber: 6024412388
FaxNumber: 8008817571
Practice Location
Address1: 10000 N. 31ST AVENUE STE. A107
Address2:  
City: PHOENIX
State: AZ
PostalCode: 85051
CountryCode: US
TelephoneNumber: 6024412388
FaxNumber: 8008817511
Other Information
ProviderEnumerationDate: 04/16/2019
LastUpdateDate: 04/16/2019
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AuthorizedOfficialLastName: RODRIGUEZ
AuthorizedOfficialFirstName: ROXANNE
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AuthorizedOfficialTitleorPosition: OFFICE MANAGER
AuthorizedOfficialTelephone: 6024412388
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
133V00000X  Y193400000X SINGLE SPECIALTY GROUPDietary & Nutritional Service ProvidersDietitian, Registered 

No ID Information.


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