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General NPI Number Information
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NPI Number | 1881118867
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Entity Type | Individual
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Provider Name | HAJA SANKOH
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Gender | Female
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 16645 WEST CENTRAL ST
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City | SURPRISE
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State | AZ
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Zip | 85388
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Country | US
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Telephone | 623-241-1982
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Fax | 623-777-0810
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Provider Business Mailing Address
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Address Line | 16645 W CENTRAL ST
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City | SURPRISE
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State | AZ
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Zip | 85388-1181
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Country | US
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Telephone | 623-241-1982
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Fax | 623-777-0810
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BH5126
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License Number State | AZ
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