Healthcare Provider Details

I. General information

NPI: 1114699311
Provider Name (Legal Business Name): ABBERDEEN ARIAM AVELAR MA,BCBA,LBA,SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2021
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3310 N 19TH AVE
PHOENIX AZ
85015-5701
US

IV. Provider business mailing address

PO BOX 740780
ATLANTA GA
30374-0780
US

V. Phone/Fax

Practice location:
  • Phone: 602-613-5645
  • Fax:
Mailing address:
  • Phone: 855-223-7123
  • Fax: 619-374-7134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBEH-000844
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number11694
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: