| NPI | 1124577192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB BONEY Clinical Director 480-410-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2016-09-30 |