Individual
FALOCQUIOUS MIGUEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2121 N 99TH AVE UNIT 2, PHOENIX, AZ 85037-4458
(229) 416-2750
Mailing address
2121 N 99TH AVE UNIT 2, PHOENIX, AZ 85037-4458
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/10/2026
Last updated
08/10/2026
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