Provider Demographics
NPI:1427580406
Name:HECTOR, AVA YOLANDE (BSC/BHT)
Entity Type:Individual
Prefix:MRS
First Name:AVA
Middle Name:YOLANDE
Last Name:HECTOR
Suffix:
Gender:F
Credentials:BSC/BHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4435 E PHELPS RD
Mailing Address - Street 2:UNION HILLS
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2822
Mailing Address - Country:US
Mailing Address - Phone:310-622-3653
Mailing Address - Fax:602-218-8860
Practice Address - Street 1:4435 E PHELPS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2822
Practice Address - Country:US
Practice Address - Phone:310-622-3653
Practice Address - Fax:602-218-8860
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-30
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH5132106E00000X, 106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst