Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacqueline Mansaram

Individual provider Behavior Technician · NPI 1912570219

Jacqueline Mansaram is a Behavior Technician in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2021.

Licensed in
AZ
In the registry since
2021
Specialties on file
2

Practice location Address checks out

4350 E Ray Rd Ste 101A
Phoenix, AZ 85044-4707
Phone: (480) 704-5954
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SLP17250 (AZ)
Behavior Technician Taxonomy 106S00000X

Record details

NPI number1912570219
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 23, 2021
Last updated in NPPESJune 5, 2026
Certification dateJune 5, 2026
Mailing address2339 E Geneva Dr, Tempe, AZ 85282-4146

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