=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669338349
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AERYN HEDLUND
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/26/2025
-----------------------------------------------------
Last Update Date | 12/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3100 W RAY RD STE 201
-----------------------------------------------------
City | CHANDLER
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85226-2472
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-832-6727
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 90 CALLE AGUA SALADA
-----------------------------------------------------
City | RIO RICO
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85648-8003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-275-9139
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106E00000X
-----------------------------------------------------
Taxonomy Name | Assistant Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------