Individual
ANNA KIM TA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
11201 N TATUM BLVD STE 100, PHOENIX, AZ 85028-6037
(720) 637-2321
Mailing address
9316 BELLEWOOD CT, HIGHLANDS RANCH, CO 80126-2706
(408) 644-2286
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
WA
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831541770
BEHAVIOR ANALYST
—
Enumeration date
11/30/2018
Last updated
05/29/2025
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