Provider Demographics
NPI:1043728157
Name:RUCHLIN, JONATHAN (BCBA)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:RUCHLIN
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10595 N TATUM BLVD STE E146
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-1072
Mailing Address - Country:US
Mailing Address - Phone:602-606-2237
Mailing Address - Fax:480-898-7419
Practice Address - Street 1:2530 E GERMANN RD STE 31
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-1406
Practice Address - Country:US
Practice Address - Phone:602-606-2237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst