Individual
JICELLE-RAE FAUSTO SANDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2730 S VAL VISTA DR BLDG 4, GILBERT, AZ 85295-1675
(480) 608-4640
Mailing address
2727 E CAMELBACK RD APT 348, PHOENIX, AZ 85016-4476
(757) 802-0685
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-73238
—
Other
Enumeration date
01/21/2021
Last updated
01/06/2025
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