Organization
BLUE SPRIG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIARRA WHITE (BT)
(480) 751-1957
Entity
Organization
Contact information
Practice address
4170 N 108TH AVE, PHOENIX, AZ 85037-5469
(480) 751-1957
Mailing address
7500 SAN FELIPE ST, HOUSTON, TX 77063-1707
(480) 751-1957
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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