Healthcare Provider Details

I. General information

NPI: 1295287548
Provider Name (Legal Business Name): ARIEL FRANKLYN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 SAN JUAN DE RIO DR SE
RIO RANCHO NM
87124-1142
US

IV. Provider business mailing address

210 SAN JUAN DE RIO DR SE
RIO RANCHO NM
87124-1142
US

V. Phone/Fax

Practice location:
  • Phone: 615-418-7105
  • Fax:
Mailing address:
  • Phone: 615-418-7105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: