Organization
ACCEL
Active
Other names
Bista
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CONNIE FLETCHER LAIRD (EXECUTIVE DIRECTOR)
(602) 995-7366
Entity
Organization
Contact information
Practice address
10251 N. 35TH AVE, PHOENIX, AZ 85051
(602) 926-7210
(602) 268-2730
Mailing address
10251 N. 35TH AVE, PHOENIX, AZ 85051
(602) 926-7210
(602) 268-2730
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
BA11
AZ
225100000X
Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
6265
AZ
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
412094
—
AZ
Enumeration date
11/20/2006
Last updated
10/11/2022
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