Individual
MARY MENDIEN BAYSAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3721 W IRWIN AVE, PHOENIX, AZ 85041-6132
(847) 401-7005
Mailing address
3721 W IRWIN AVE, PHOENIX, AZ 85041-6132
(847) 401-7005
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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