Provider Demographics
NPI:1356726731
Name:DENTON, TISHA (BCBA, LBA, IBA)
Entity type:Individual
Prefix:MRS
First Name:TISHA
Middle Name:
Last Name:DENTON
Suffix:
Gender:F
Credentials:BCBA, LBA, IBA
Other - Prefix:
Other - First Name:TISHA
Other - Middle Name:
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1118 S 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-2558
Mailing Address - Country:US
Mailing Address - Phone:026-600-9872
Mailing Address - Fax:
Practice Address - Street 1:15333 N PIMA RD STE 305-H
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2783
Practice Address - Country:US
Practice Address - Phone:480-769-5302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
AZBEH-000189103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst