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NPI Code Detail

MEDICARE: MARK CHRISTOPHER VIOLETTI M.A., BCBA, LBA

MEDICARE: MARK CHRISTOPHER VIOLETTI M.A., BCBA, LBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-18-32481CA

General Provider Information

NPI Number : 1205363066
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK CHRISTOPHER VIOLETTI M.A., BCBA, LBA
Provider Business Mailing Address
First Line : 4953 E BARWICK DR
Second Line :
City : CAVE CREEK
State : AZ
Zip : 85331-3327
Country : US
Telephone Number : 530-262-5579
Fax Number :
Provider Business Practice Location Address
First Line : 20601 N 19TH AVE STE 100
Second Line :
City : PHOENIX
State : AZ
Zip : 85027-2666
Country : US
Telephone Number : 888-754-0398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2017
Last Update Date : 06/17/2025

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