Individual provider · NPI-1

Kellie L Cardoza, BHT

Day Training/Habilitation Specialist · Glendale, AZ

NPI number1669072161
StatusActive
Last updated in NPPESOct 26, 2020

Details

NPI
1669072161
Entity type
Individual (NPI-1)
Name
Kellie L Cardoza
Credential
BHT
Sex
Female
Sole proprietor
No
Enumeration date
Oct 26, 2020
Certification date
Oct 26, 2020
Last updated
Oct 26, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
373H00000X Day Training/Habilitation Specialist––Yes

Practice location

6148 W Frier Dr
Glendale, AZ 85301-1223

Phone 315-955-0170

Mailing address

6148 W Frier Dr
Glendale, AZ 85301-1223

Phone 315-955-0170

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