Most Relevant Information
Provider Data
| NPI Number: | 1003568148 |
| Provider Name: | VAVRIX OWENS RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-22-200412 |
Most Important Dates
| Enumeration Date: | 01/20/2022 |
| Last Updated: | 01/20/2022 |
Provider Practice Location
6550 E BROADWAY RD STE 110
MESA
AZ
852061734
Practice Location Phone/Fax
| Phone: | 4806720772 |
| Fax: | 3175208200 |
Provider Mailing Location
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS
IN
462686135
Provider Mailing Phone/Fax
| Phone: | 8553240885 |
| Fax: | 3175208200 |