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General NPI Number Information
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NPI Number | 1821666439
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Entity Type | Organization
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Legal Business Name | SOUTHWEST AUTISM RESEARCH AND RESOURCE CENTER
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Dates
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Enumeration Date | 06/11/2021
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 300 N 18TH ST
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City | PHOENIX
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State | AZ
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Zip | 85006-4103
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Country | US
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Telephone | 602-340-8717
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Fax |
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Provider Business Mailing Address
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Address Line | 2225 N 16TH ST
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City | PHOENIX
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State | AZ
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Zip | 85006-1823
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Country | US
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Telephone | 602-340-8717
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF FINANCE
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Name | BRIAN SHAW
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Credential |
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Telephone | 602-340-8717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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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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