Individual
KING FANENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
13700 N DYSART RD, SURPRISE, AZ 85379-3319
(855) 223-7123
Mailing address
PO BOX 740780, ATLANTA, GA 30374-0780
(855) 223-7123
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-339890
AZ
Other
Enumeration date
06/10/2024
Last updated
05/06/2026
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