Most Relevant Information
Provider Data
| NPI Number: | 1003662461 |
| Provider Name: | SELENA GASTELUM |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/26/2024 |
| Last Updated: | 04/26/2024 |
Provider Practice Location
4350 E RAY RD
PHOENIX
AZ
850444703
Practice Location Phone/Fax
| Phone: | 6026665101 |
| Fax: |
Provider Mailing Location
4350 E RAY RD
PHOENIX
AZ
850444703
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |