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General NPI Number Information
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NPI Number | 1467710723
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Entity Type | Organization
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Legal Business Name | SEEDS FOR AUTISM
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 04/24/2012
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Provider Practice Location Address
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Address Line | 711 N 15TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85007-2251
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Country | US
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Telephone | 602-279-6702
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Fax |
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Provider Business Mailing Address
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Address Line | 1775 E OCOTILLO RD
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City | PHOENIX
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State | AZ
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Zip | 85016-1039
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Country | US
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Telephone | 602-279-6702
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. MARY ANN LAROCHE
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Credential |
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Telephone | 602-989-1242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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