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NPI Code Detail

MEDICARE: AMANDA VERONICA VALE

MEDICARE: AMANDA VERONICA VALE
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 AnalystBEH-000877AZ

General Provider Information

NPI Number : 1225511165
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA VERONICA VALE
Provider Business Mailing Address
First Line : 2301 E YEAGER DR STE 14
Second Line :
City : CHANDLER
State : AZ
Zip : 85286-1578
Country : US
Telephone Number : 602-606-2237
Fax Number : 844-475-2307
Provider Business Practice Location Address
First Line : 15220 S 50TH ST STE 103
Second Line :
City : PHOENIX
State : AZ
Zip : 85044-9132
Country : US
Telephone Number : 480-795-7165
Fax Number : 844-475-2307
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2018
Last Update Date : 06/29/2022

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Directions to “ AMANDA VERONICA VALE ” Practice Location

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