Individual
MARICELA MOYA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4520 E BASELINE RD APT 2019, PHOENIX, AZ 85042-6453
(928) 488-9624
Mailing address
4520 E BASELINE RD APT 2019, PHOENIX, AZ 85042-6453
(928) 488-9624
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
D05512288
AZ
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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