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NPI Code Detail

MEDICARE: BRIAH JUNE CLANTON

MEDICARE: BRIAH JUNE CLANTON
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1831933514
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAH JUNE CLANTON
Provider Business Mailing Address
First Line : 1003 W WASHINGTON ST
Second Line :
City : TEMPE
State : AZ
Zip : 85288-0924
Country : US
Telephone Number : 731-676-9614
Fax Number :
Provider Business Practice Location Address
First Line : 665 N GILBERT RD STE 152
Second Line :
City : GILBERT
State : AZ
Zip : 85234-3395
Country : US
Telephone Number : 480-241-4095
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2024
Last Update Date : 06/19/2024

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Directions to “ BRIAH JUNE CLANTON ” Practice Location

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