Individual
KELSEY E COCHRANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
14040 N CAVE CREEK RD STE 205, PHOENIX, AZ 85022-6179
(602) 358-7073
(888) 927-0409
Mailing address
23380 N 61ST DR, GLENDALE, AZ 85310-5748
(602) 358-7073
(888) 927-0409
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12-16-2016
NORTHERN ARIZONA UNIVERSITY
AZ
Enumeration date
10/11/2022
Last updated
10/11/2022
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