| Into The Spectrum Services Llc | |
|
4340 E Indian School Rd Ste 21-194 Phoenix AZ 85018-5390 | |
| (602) 377-9980 | |
| Not Available |
| Full Name | Into The Spectrum Services Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4340 E Indian School Rd Ste 21-194, Phoenix, Arizona |
| Authorized Official Name and Position | Courtney Peters (CLINICAL DIRECTOR) |
| Authorized Official Contact | 6023779980 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Into The Spectrum Services Llc 4340 E Indian School Rd Ste 21-194 Phoenix AZ 85018-5390 Ph: (602) 377-9980 | Into The Spectrum Services Llc 4340 E Indian School Rd Ste 21-194 Phoenix AZ 85018-5390 Ph: (602) 377-9980 |
| NPI Number | 1831676998 |
|---|---|
| Provider Enumeration Date | 07/23/2018 |
| Last Update Date | 07/27/2022 |
| Certification Date | 07/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831676998 | NPI | - | NPPES |
| 1972859841 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 222Q00000X | Developmental Therapist | (* (Not Available)) | Secondary |
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