Individual
JAJUANA K LARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
11225 N 28TH DR STE C202, PHOENIX, AZ 85029-5600
(480) 953-3888
Mailing address
105 N BEEBE ST APT 2025, GILBERT, AZ 85234-7687
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
106S00000X
AZ
Other
Enumeration date
03/23/2026
Last updated
03/23/2026
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