Individual
CHOL BOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7711 E BEATRICE ST, SCOTTSDALE, AZ 85257-4434
(623) 213-9207
Mailing address
7711 E BEATRICE ST, SCOTTSDALE, AZ 85257-4434
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
00000000000000000000
AZ
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/12/2024
Last updated
12/12/2024
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