Healthcare Provider Details

I. General information

NPI: 1396665378
Provider Name (Legal Business Name): REDEMPTA UMUTONI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 S HARDY DR STE 105
TEMPE AZ
85282-3329
US

IV. Provider business mailing address

1367 S COUNTRY CLUB DR UNIT 1163
MESA AZ
85210-5296
US

V. Phone/Fax

Practice location:
  • Phone: 602-805-9237
  • Fax:
Mailing address:
  • Phone: 218-671-1705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-446387
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: