Individual
BENJAMIN BRODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6232 N 7TH ST, PHOENIX, AZ 85014-1839
(623) 693-2954
(623) 399-1337
Mailing address
4340 E NISBET RD, PHOENIX, AZ 85032-8105
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-48052
—
Other
Enumeration date
01/19/2018
Last updated
01/19/2018
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