Healthcare Provider Details

I. General information

NPI: 1851203103
Provider Name (Legal Business Name): BRYANNA SUE ECKROTE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2551 E COCHISE VIS
TUCSON AZ
85713-5175
US

IV. Provider business mailing address

2551 E COCHISE VIS
TUCSON AZ
85713-5175
US

V. Phone/Fax

Practice location:
  • Phone: 520-764-8622
  • Fax:
Mailing address:
  • Phone: 520-764-8622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: