Individual
MARIAH LOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3150 N 24TH ST STE C102, PHOENIX, AZ 85016-7343
(602) 206-6046
Mailing address
3150 N 24TH ST STE C102, PHOENIX, AZ 85016-7343
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA-0252
AZ
Other
Enumeration date
11/14/2016
Last updated
09/10/2018
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