Individual
ADESUWA AYESHA OSAYAREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20470 N LAKE PLEASANT RD STE 107, PEORIA, AZ 85382-9708
(800) 376-3400
Mailing address
20470 N LAKE PLEASANT RD STE 107, PEORIA, AZ 85382-9708
(800) 376-3400
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-134985
AZ
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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