Organization
APPLIED BEHAVIORAL INTERVENTIONS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR OBIDIKE OKORIE PH.D. (CHIEF EXECUTIVE OFFICER)
(602) 524-0824
Entity
Organization
Contact information
Practice address
472 E WICKENBURG WAY STE 106, WICKENBURG, AZ 85390-1602
(928) 919-1528
Mailing address
PO BOX 72657, PHOENIX, AZ 85050-1028
(928) 919-1528
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
4725
AZ
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
11/27/2017
Last updated
11/27/2017
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