Individual
KIYOSHI FISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
13571 W REMUDA DR, PEORIA, AZ 85383-8305
(602) 577-6352
Mailing address
13571 W REMUDA DR, PEORIA, AZ 85383-8305
(602) 577-6352
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/08/2022
Last updated
03/08/2022
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