Healthcare Provider Details

I. General information

NPI: 1245168822
Provider Name (Legal Business Name): ALLIE PAIGE VAN DYN HOVEN RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2741 S 8TH AVE STE A
YUMA AZ
85364-7154
US

IV. Provider business mailing address

2741 S 8TH AVE STE A
YUMA AZ
85364-7154
US

V. Phone/Fax

Practice location:
  • Phone: 928-782-1338
  • Fax:
Mailing address:
  • Phone: 928-782-1338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-678366
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: