Individual
JADE PLACER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21635 N DIAMOND DR, MARICOPA, AZ 85138-9577
(908) 216-8274
Mailing address
21635 N DIAMOND DR, MARICOPA, AZ 85138-9577
(908) 216-8274
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/20/2023
Last updated
12/20/2023
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