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General NPI Number Information
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NPI Number | 1114877685
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Entity Type | Individual
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Provider Name | TI'ARA MINATEE
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Gender | Female
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 12409 W INDIAN SCHOOL RD STE B210
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City | AVONDALE
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State | AZ
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Zip | 85392-9505
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Country | US
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Telephone | 855-223-7123
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Fax | 619-374-7134
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Provider Business Mailing Address
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Address Line | PO BOX 740780
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City | ATLANTA
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State | GA
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Zip | 30374-0780
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Country | US
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Telephone | 855-223-7123
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Fax | 619-374-7134
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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