Provider Demographics
NPI:1720647316
Name:SAINT JUSTE, MARIE JOLENE
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:JOLENE
Last Name:SAINT JUSTE
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 1:8218 W ATLANTIS WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85043-1559
Mailing Address - Country:US
Mailing Address - Phone:480-843-2969
Mailing Address - Fax:480-525-4983
Practice Address - Street 1:8218 W ATLANTIS WAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85043-1559
Practice Address - Country:US
Practice Address - Phone:480-843-2969
Practice Address - Fax:480-525-4983
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician