Healthcare Provider Details

I. General information

NPI: 1508170879
Provider Name (Legal Business Name): VANDANA SINGH BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 N 25TH ST
PHOENIX AZ
85008-1010
US

IV. Provider business mailing address

1131 S. PHEASANT DRIVE
GILBERT AZ
85296
US

V. Phone/Fax

Practice location:
  • Phone: 25-176-7566
  • Fax:
Mailing address:
  • Phone: 480-516-1785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number3825686
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7955
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0517
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: