Provider Demographics
NPI:1710655469
Name:GELANDER, EMILY CLAIRE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:CLAIRE
Last Name:GELANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12725 W INDIAN SCHOOL RD BLDG D
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-9520
Mailing Address - Country:US
Mailing Address - Phone:602-638-3300
Mailing Address - Fax:
Practice Address - Street 1:12725 W INDIAN SCHOOL RD BLDG D
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-9520
Practice Address - Country:US
Practice Address - Phone:602-638-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBEH-001352103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst