Organization
SCOTTSDALE PEDIATRIC BEHAVIORAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB BONEY PSY.D. (CLINICAL DIRECTOR)
(480) 410-4040
Entity
Organization
Contact information
Practice address
22555 N MILLER RD, SUITE 100, SCOTTSDALE, AZ 85255-4944
(480) 410-4040
Mailing address
22555 N MILLER RD, SUITE 100, SCOTTSDALE, AZ 85255-4944
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/30/2016
Last updated
09/30/2016
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