| Blue Sprig | |
|
4170 N 108th Ave Phoenix AZ 85037-5469 | |
| (480) 751-1957 | |
| Not Available |
| Full Name | Blue Sprig |
|---|---|
| Speciality | Behavior Technician |
| Location | 4170 N 108th Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Kiarra White (BT) |
| Authorized Official Contact | 4807511957 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Sprig 7500 San Felipe St Houston TX 77063-1707 Ph: (480) 751-1957 | Blue Sprig 4170 N 108th Ave Phoenix AZ 85037-5469 Ph: (480) 751-1957 |
| NPI Number | 1073286712 |
|---|---|
| Provider Enumeration Date | 07/28/2021 |
| Last Update Date | 07/28/2021 |
| Certification Date | 07/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073286712 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106S00000X | Behavior Technician | (* (Not Available)) | Primary |
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