Individual
GINAMARIE NIEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4343 N 16TH ST, PHOENIX, AZ 85016-5338
(602) 274-4343
(480) 573-3592
Mailing address
4343 N 16TH ST, PHOENIX, AZ 85016-5338
(602) 274-4343
(480) 573-3592
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/14/2021
Last updated
07/31/2021
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