Individual
ANNA MALBOEUF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 N 18TH ST, PHOENIX, AZ 85006-4103
(602) 340-8717
Mailing address
300 N 18TH ST, PHOENIX, AZ 85006-4103
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BEH-000870
AZ
106S00000X
Behavior Technician
RBT-17-46150
AZ
Other
Enumeration date
01/03/2018
Last updated
08/28/2024
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