Provider Demographics
NPI:1851956908
Name:REID, MARIAH (BCBA)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:REID
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 E REDFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-4545
Mailing Address - Country:US
Mailing Address - Phone:602-423-0161
Mailing Address - Fax:
Practice Address - Street 1:2225 N 16TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-1823
Practice Address - Country:US
Practice Address - Phone:602-340-8720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst