Individual
ETIENNE KAMANZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3420 E SHEA BLVD STE 200, PHOENIX, AZ 85028-3348
(720) 495-0311
Mailing address
3420 E SHEA BLVD STE 200, PHOENIX, AZ 85028-3348
(720) 495-0311
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/07/2023
Last updated
03/07/2023
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