Individual
AUTUMN STASZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1413 E MINERAL RD, GILBERT, AZ 85234-4853
(480) 888-5287
Mailing address
1413 E MINERAL RD, GILBERT, AZ 85234-4853
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-132325
AZ
106S00000X
Behavior Technician
—
—
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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