Organization
GENTRY PEDIATRIC BEHAVIORAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH GENTRY PH.D., BCBA-D (PRESIDENT/CEO)
(602) 312-2911
Entity
Organization
Contact information
Practice address
7600 N 16TH ST, SUITE 218, PHOENIX, AZ 85020-4431
(602) 312-2911
Mailing address
7600 N 16TH ST, SUITE 218, PHOENIX, AZ 85020-4431
(602) 312-2911
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
BA-15
AZ
103T00000X
Psychologist
Primary
3913
AZ
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TS0200X
School Psychologist
—
—
Other
Enumeration date
03/06/2013
Last updated
03/06/2013
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