Individual
MRS. LARISSA MERCADISE FEARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
5025 E WASHINGTON ST STE 212, PHOENIX, AZ 85034-7439
(602) 773-5775
Mailing address
2150 S 55TH ST APT 2128, TEMPE, AZ 85282-2376
(480) 589-3292
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BEH-001154
AZ
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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