Provider Demographics
NPI:1508616772
Name:CHRISTENSEN, ORCHIDEH (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:ORCHIDEH
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:ORCHID
Other - Middle Name:
Other - Last Name:PYLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCBA, LBA
Mailing Address - Street 1:37200 N GANTZEL RD STE 150
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-7383
Mailing Address - Country:US
Mailing Address - Phone:520-484-1111
Mailing Address - Fax:
Practice Address - Street 1:37200 N GANTZEL RD STE 150
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-7383
Practice Address - Country:US
Practice Address - Phone:520-484-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBEH-001181103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst