Individual
DENISE MARIE FARRALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5060 N 19TH AVE, PHOENIX, AZ 85015-3210
(602) 400-7658
Mailing address
5060 N 19TH AVE STE 300-27, PHOENIX, AZ 85015-3210
(605) 815-7644
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/22/2023
Last updated
08/23/2023
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