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Individual

JIMMY MUYUMBU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
10835 N 25TH AVE STE 125, PHOENIX, AZ 85029-3461
(520) 331-5287
Mailing address
10835 N 25TH AVE STE 125, PHOENIX, AZ 85029-3461
(520) 331-5287

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
171M00000X
Case Manager/Care Coordinator
172A00000X
Driver
373H00000X
Day Training/Habilitation Specialist

Other

Enumeration date
08/09/2022
Last updated
12/06/2022
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