Sandra Moultrie
Behavior Technician in Phoenix, AZ. Individual provider (NPI-1).
NPI number1124888045
StatusActive
Last updated in NPPESMar 19, 2024
Details
- NPI
- 1124888045
- Entity type
- Individual (NPI-1)
- Name
- Sandra Moultrie
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 19, 2024
- Certification date
- Mar 19, 2024
- Last updated
- Mar 19, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1817 N 7th StPhoenix, AZ 85006-2100
Phone 602-257-3755
Mailing address
5517 S 11th PlPhoenix, AZ 85040-5103
Phone 480-527-8988
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