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Individual

ANTOINETTE MALINDA WELLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BA

Contact information

Practice address
600 W RAY RD STE D3, CHANDLER, AZ 85225-7266
(480) 628-5339
Mailing address
2620 E AUGUSTA AVE, CHANDLER, AZ 85249-4875
(480) 628-5339

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
06/05/2018
Last updated
06/05/2018
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