Healthcare Provider Details

I. General information

NPI: 1750913364
Provider Name (Legal Business Name): ARIZONA AUTISM UNITED, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2020
Last Update Date: 02/16/2020
Certification Date: 02/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4309 E FLORIAN AVE
MESA AZ
85206-2798
US

IV. Provider business mailing address

5025 E WASHINGTON ST STE 212
PHOENIX AZ
85034-7439
US

V. Phone/Fax

Practice location:
  • Phone: 602-773-5773
  • Fax: 602-273-9108
Mailing address:
  • Phone: 602-773-5773
  • Fax: 602-273-9108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: AARON BLOCHER-RUBIN
Title or Position: CEO
Credential: PHD
Phone: 602-773-5774