Individual
MARY DECARLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 N 18TH ST, PHOENIX, AZ 85006-4103
(602) 376-2019
Mailing address
300 N 18TH ST, PHOENIX, AZ 85006-4103
(602) 376-2019
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA-0227
AZ
Other
Enumeration date
06/24/2016
Last updated
07/07/2016
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