Individual
AUTUMN EISENHUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5701 W TALAVI BLVD, GLENDALE, AZ 85306-1886
(855) 223-7123
(619) 374-7134
Mailing address
PO BOX 740780, ATLANTA, GA 30374-0780
(855) 223-7123
(619) 374-7134
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-330130
AZ
Other
Enumeration date
03/06/2026
Last updated
03/06/2026
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