Individual
ELIZABETH BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1046 N GILA VERDE, MESA, AZ 85207-4900
(480) 516-9500
Mailing address
1046 N GILA VERDE, MESA, AZ 85207-4900
(480) 516-9500
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
4723090
AZ
Other
Enumeration date
01/22/2014
Last updated
01/22/2014
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