Individual
MARTHA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3454 KIMBERLY LN, CHINO VALLEY, AZ 86323-5006
(928) 277-6589
Mailing address
PO BOX 1586, CHINO VALLEY, AZ 86323-1586
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/30/2017
Last updated
11/30/2017
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