| The Bista Center | |
|
10251 N 35th Ave Phoenix AZ 85051-1305 | |
| (602) 926-7200 | |
| Not Available |
| Full Name | The Bista Center |
|---|---|
| Speciality | Behavior Analyst |
| Location | 10251 N 35th Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Lisa M Stewart (CLINICAL SUPERVISOR) |
| Authorized Official Contact | 6029267200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Bista Center 10251 N 35th Ave Phoenix AZ 85051-1305 Ph: (602) 926-7200 | The Bista Center 10251 N 35th Ave Phoenix AZ 85051-1305 Ph: (602) 926-7200 |
| NPI Number | 1154695799 |
|---|---|
| Provider Enumeration Date | 02/29/2012 |
| Last Update Date | 02/29/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154695799 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | BA-62 (Arizona) | Primary |
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