Provider Demographics
NPI:1497411185
Name:UNIQUELY YOU PLLC
Entity Type:Organization
Organization Name:UNIQUELY YOU PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIENER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LBA, BCBA
Authorized Official - Phone:480-375-0478
Mailing Address - Street 1:17425 E CALIENTE DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-2632
Mailing Address - Country:US
Mailing Address - Phone:480-375-0478
Mailing Address - Fax:
Practice Address - Street 1:4150 W PEORIA AVE STE 122
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-3951
Practice Address - Country:US
Practice Address - Phone:480-375-0478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty