Individual
JENNIFER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
3420 E SHEA BLVD STE 200, PHOENIX, AZ 85028-3348
(520) 485-8846
Mailing address
8002 E 50TH DR, DENVER, CO 80238-3299
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1991307
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1991307
RBT
AZ
Enumeration date
03/27/2020
Last updated
03/27/2020
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