Individual
IZHAC PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1817 N 7TH ST, PHOENIX, AZ 85006-2100
(602) 257-3755
Mailing address
2030 N 60TH DR, PHOENIX, AZ 85035-3534
(915) 990-9909
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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