Healthcare Provider Details

I. General information

NPI: 1538948591
Provider Name (Legal Business Name): JESSE D RHODES BCBA, LBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2023
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2314 S VAL VISTA DR STE 201
GILBERT AZ
85295-5594
US

IV. Provider business mailing address

2314 S VAL VISTA DR STE 201
GILBERT AZ
85295-5594
US

V. Phone/Fax

Practice location:
  • Phone: 623-263-3966
  • Fax:
Mailing address:
  • Phone: 623-263-3966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number13570237-2506
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: