Individual
ACLEO KATUSABE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4822 W GWEN ST, LAVEEN, AZ 85339-4200
(336) 405-7510
Mailing address
4822 W GWEN ST, LAVEEN, AZ 85339-4200
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
01/22/2026
Last updated
01/22/2026
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