| Blue Cactus Aba Llc | |
|
3961 E Norcroft Cir Mesa AZ 85215-1084 | |
| (360) 791-3733 | |
| Not Available |
| Full Name | Blue Cactus Aba Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3961 E Norcroft Cir, Mesa, Arizona |
| Authorized Official Name and Position | Jennica Kristine Warner (CEO) |
| Authorized Official Contact | 4805363343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Cactus Aba Llc 3961 E Norcroft Cir Mesa AZ 85215-1084 Ph: (360) 791-3733 | Blue Cactus Aba Llc 3961 E Norcroft Cir Mesa AZ 85215-1084 Ph: (360) 791-3733 |
| NPI Number | 1730951393 |
|---|---|
| Provider Enumeration Date | 10/26/2023 |
| Last Update Date | 04/12/2024 |
| Certification Date | 11/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730951393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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