| Kaibab Behavioral Services, Pllc | |
|
2323 E Greenlaw Lane Suite 12a Flagstaff AZ 86004 | |
| (928) 607-1280 | |
| Not Available |
| Full Name | Kaibab Behavioral Services, Pllc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2323 E Greenlaw Lane, Flagstaff, Arizona |
| Authorized Official Name and Position | Brian Vanmeerten (MANAGER/MEMBER) |
| Authorized Official Contact | 9286071280 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaibab Behavioral Services, Pllc 2323 E Greenlaw Lane Suite 12a Flagstaff AZ 86004 Ph: (928) 607-1280 | Kaibab Behavioral Services, Pllc 2323 E Greenlaw Lane Suite 12a Flagstaff AZ 86004 Ph: (928) 607-1280 |
| NPI Number | 1992295745 |
|---|---|
| Provider Enumeration Date | 05/17/2018 |
| Last Update Date | 05/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992295745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | BA-72 (Arizona) | Primary |
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