Individual
MAYA ROYCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3744 MARTINGALE DR, KINGMAN, AZ 86409-2994
(928) 255-1747
Mailing address
33105 N 23RD AVE, PHOENIX, AZ 85085-5088
(623) 285-9595
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BH4985
AZ
Other
Enumeration date
09/27/2016
Last updated
09/27/2016
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