Healthcare Provider Details
I. General information
NPI: 1710597265
Provider Name (Legal Business Name): ARIANNA Y CUEVAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/08/2020
Last Update Date: 10/04/2021
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
238 S MERIDIAN RD
YOUNGSTOWN OH
44509-2925
US
IV. Provider business mailing address
238 S MERIDIAN RD
YOUNGSTOWN OH
44509-2925
US
V. Phone/Fax
- Phone: 330-318-3436
- Fax:
- Phone: 330-318-3436
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: