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General NPI Number Information
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NPI Number | 1750885547
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Entity Type | Organization
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Legal Business Name | FULL SPECTRUM BEHAVIORAL SOLUTIONS, PLLC
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Dates
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Enumeration Date | 03/19/2018
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 508 E ORION ST
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City | TEMPE
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State | AZ
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Zip | 85283-2880
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Country | US
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Telephone | 617-538-6245
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Fax |
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Provider Business Mailing Address
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Address Line | 508 E ORION ST
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City | TEMPE
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State | AZ
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Zip | 85283-2880
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Country | US
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Telephone | 602-909-8630
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Fax |
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Authorized Official
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Title or Position | BOARD CERTIFIED BEHAVIOR ANALYST
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Name | REBECCA PAWLOWSKI
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Credential | DBH, BCBA-LBA
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Telephone | 602-529-6950
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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 |
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