Individual
BETHANY LYNN DEMORE CHADD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
300 N 18TH ST, PHOENIX, AZ 85006-4103
(602) 340-8717
Mailing address
5118 N 32ND PL, PHOENIX, AZ 85018-1407
(602) 330-8132
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-10-6913
AZ
Other
Enumeration date
07/01/2010
Last updated
07/01/2010
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