Healthcare Provider Details

I. General information

NPI: 1134744451
Provider Name (Legal Business Name): ARIEL KHY RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2020
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 MARINER BLVD
SPRING HILL FL
34609-5691
US

IV. Provider business mailing address

7936 HAMPTON LAKE DR
TAMPA FL
33647-3661
US

V. Phone/Fax

Practice location:
  • Phone: 800-217-9289
  • Fax:
Mailing address:
  • Phone: 847-331-2629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-117069
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: