Individual
NICOLE BALISTRIERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5025 E WASHINGTON ST, PHOENIX, AZ 85034-7437
(602) 773-5773
Mailing address
4530 E MUIRWOOD DR STE 103, PHOENIX, AZ 85048-7693
(480) 610-6981
(480) 898-7419
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BEH-001011
AZ
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/18/2018
Last updated
04/14/2023
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