Provider Demographics
NPI:1184862682
Name:JUAREZ, ERIN MARIE (MA, BCBA)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:MARIE
Last Name:JUAREZ
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 N COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85201-4108
Mailing Address - Country:US
Mailing Address - Phone:809-693-8004
Mailing Address - Fax:
Practice Address - Street 1:4250 E FLORIAN AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-2797
Practice Address - Country:US
Practice Address - Phone:480-969-3800
Practice Address - Fax:480-307-9771
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-09-5785103K00000X
AZ138103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst