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General NPI Number Information
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NPI Number | 1285369306
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Entity Type | Individual
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Provider Name | MARLUZ FERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 07/21/2022
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 15333 N PIMA RD STE 305-H
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-2783
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Country | US
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Telephone | 915-315-4354
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Fax |
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Provider Business Mailing Address
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Address Line | 1019 E UNIVERSITY DR APT 301
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City | TEMPE
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State | AZ
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Zip | 85288-4290
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Country | US
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Telephone | 915-315-4354
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Fax |
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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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