Individual
CLARISSA BROOKE DEWESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4480 W PEORIA AVE STE 201, GLENDALE, AZ 85302-2039
(702) 743-4108
Mailing address
4480 W PEORIA AVE STE 201, GLENDALE, AZ 85302-2039
(602) 400-0231
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/27/2023
Last updated
05/23/2023
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