Individual
MELISSA CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4449 N 12TH STREET, PHOENIX, AZ 85014-4520
(602) 279-1427
(602) 279-1431
Mailing address
P.O. BOX 16906, PHOENIX, AZ 85011-6906
(602) 279-1427
(602) 279-1431
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
6491023
AZ
104100000X
Social Worker
Primary
6491023
AZ
Other
Enumeration date
03/17/2015
Last updated
12/30/2015
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