Healthcare Provider Details

I. General information

NPI: 1598211872
Provider Name (Legal Business Name): KIEVA HRANCHUK BCBA-D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 01/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22555 N MILLER RD SUITE 110
SCOTTSDALE AZ
85255-4944
US

IV. Provider business mailing address

8311 E VIA DE VENTURA APT 2005
SCOTTSDALE AZ
85258-6600
US

V. Phone/Fax

Practice location:
  • Phone: 480-410-4040
  • Fax:
Mailing address:
  • Phone: 917-613-5042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number249
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: