Healthcare Provider Details
I. General information
NPI: 1902038532
Provider Name (Legal Business Name): ERIC ROBERT FREY MA, BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/15/2009
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2985 W DAKOTA VISTA WAY
TUCSON AZ
85746-0020
US
IV. Provider business mailing address
2985 W DAKOTA VISTA WAY
TUCSON AZ
85746-0020
US
V. Phone/Fax
- Phone: 520-481-0059
- Fax: 480-535-4839
- Phone: 520-481-0059
- Fax: 480-535-4839
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-04-1905 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 51 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: