Healthcare Provider Details

I. General information

NPI: 1336876325
Provider Name (Legal Business Name): ASHLEY CLEVE PELOYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2022
Last Update Date: 07/15/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 DEMOSS ST
LORDSBURG NM
88045
US

IV. Provider business mailing address

530 DEMOSS ST
LORDSBURG NM
88045
US

V. Phone/Fax

Practice location:
  • Phone: 575-800-1467
  • Fax:
Mailing address:
  • Phone: 575-800-1467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: