Individual
KATHIA ELLIOTT ENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5060 N 19TH AVE STE 406-5, PHOENIX, AZ 85015-3210
(910) 977-6894
Mailing address
5060 N 19TH AVE STE 406-5, PHOENIX, AZ 85015-3210
(910) 977-6894
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/22/2022
Last updated
09/22/2022
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