Individual
ASHLEY PORTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4602 E UNIVERSITY DR STE 130, PHOENIX, AZ 85034-7430
(188) 875-4039
Mailing address
777 W CHANDLER BLVD APT 1277, CHANDLER, AZ 85225-2534
(870) 323-2562
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/07/2021
Last updated
04/07/2021
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