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NPI Code Detail

MEDICARE: TATUM LEE HUSTI

MEDICARE: TATUM LEE HUSTI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1447094164
Entity Type Code : Individual
Provider Name (Legal Business Name) : TATUM LEE HUSTI
Provider Business Mailing Address
First Line : 736 E CHILTON DR
Second Line :
City : TEMPE
State : AZ
Zip : 85283-4619
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 665 N GILBERT RD STE 152
Second Line :
City : GILBERT
State : AZ
Zip : 85234-3395
Country : US
Telephone Number : 602-726-2300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2024
Last Update Date : 06/19/2024

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Directions to “ TATUM LEE HUSTI ” Practice Location

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