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1760050090
DEREK MIX
SCOTTSDALE, AZ
NPI
1760050090
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: AZ RBT-21-171093)
Enumeration Date
2021-06-14
Last Update Date
2021-06-14
Business Address
DEREK MIX RBT
21000 N PIMA RD
SCOTTSDALE, AZ 85255-6665
Phone number: 480-535-3828
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Mailing Address
DEREK MIX RBT
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS, IN 46268-6135
Phone number: 855-324-0885
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