Individual
AKETZALI BALDERRAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
10150 W DESERT RIVER BLVD STE 160, GLENDALE, AZ 85307-3010
(623) 693-2954
Mailing address
6232 N 7TH ST STE 100, PHOENIX, AZ 85014-1850
(623) 693-2954
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BEH-000664
AZ
106S00000X
Behavior Technician
RBT-18-60729
AZ
Other
Enumeration date
07/26/2018
Last updated
03/15/2021
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