Individual
BRAIDEN ROY SOLOMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
435 N 5TH ST, PHOENIX, AZ 85004-2157
(602) 298-4016
Mailing address
857 E 5TH ST, MESA, AZ 85203-7211
(602) 715-5898
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
RBT-23-256292
AZ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
AZ
Other
Enumeration date
04/03/2023
Last updated
06/22/2023
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