Individual
JIMMY TOMUSANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2021 WEST HAYWOOD #30, PHOENIX, AZ 85021
(818) 294-3365
Mailing address
106 W OSBORN RD # 1023, PHOENIX, AZ 85013-3909
(818) 294-3365
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/19/2022
Last updated
12/19/2022
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