Provider Demographics
NPI:1023250230
Name:BLOCHER-RUBIN, AARON (MBA, BCBA, LBA)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:
Last Name:BLOCHER-RUBIN
Suffix:
Gender:M
Credentials:MBA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5025 E WASHINGTON ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-7437
Mailing Address - Country:US
Mailing Address - Phone:602-773-5774
Mailing Address - Fax:602-273-9108
Practice Address - Street 1:5025 E WASHINGTON ST
Practice Address - Street 2:SUITE 212
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-7437
Practice Address - Country:US
Practice Address - Phone:602-773-5774
Practice Address - Fax:602-273-9108
Is Sole Proprietor?:No
Enumeration Date:2009-04-02
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-08-4598103K00000X
AZBA-14103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1-08-4598OtherBEHAVIOR ANALYST CERTIFICATION BOARD
AZBA-14OtherSTATE OF ARIZONA BOARD OF PSYCHOLOGIST EXAMINERS