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General NPI Number Information
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NPI Number | 1710800099
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Entity Type | Individual
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Provider Name | JENNIFER OLAGUE CARRANZA
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Gender | Female
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 12100 N DYSART RD
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City | EL MIRAGE
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State | AZ
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Zip | 85335
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Country | US
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Telephone | 602-887-0706
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Fax |
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Provider Business Mailing Address
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Address Line | 12513 W WINDROSE DR
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City | EL MIRAGE
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State | AZ
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Zip | 85335-6210
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Country | US
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Telephone |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | AZ
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