Individual
MARLUZ FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15333 N PIMA RD STE 305-H, SCOTTSDALE, AZ 85260-2783
(915) 315-4354
Mailing address
1019 E UNIVERSITY DR APT 301, TEMPE, AZ 85288-4290
(915) 315-4354
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40944009
DL
TX
Enumeration date
07/21/2022
Last updated
07/21/2022
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