Individual
STEPHANIE CANONICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2730 S VAL VISTA DR, GILBERT, AZ 85295-1675
(480) 608-4640
Mailing address
10240 E ISLETA AVE, MESA, AZ 85209-7768
(914) 980-2293
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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