Individual
KIMBERLY AVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17235 N 75TH AVE, SUITE G-120, GLENDALE, AZ 85308-0831
(303) 989-8169
Mailing address
17235 N 75TH AVE, SUITE G-120, GLENDALE, AZ 85308-0831
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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