Individual
ELISE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
15220 S 50TH ST STE 103, PHOENIX, AZ 85044-9132
(480) 779-6316
Mailing address
15220 S 50TH ST STE 103, PHOENIX, AZ 85044-9132
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BEH-001850
AZ
Other
Enumeration date
04/15/2025
Last updated
04/15/2025
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