MEDICARE: ADRIANA PRIETO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1417220047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANA PRIETO

Provider Business Mailing Address
First Line	:	1514 N KANSAS ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-4233
Country	:	US
Telephone Number	:	915-317-0980
Fax Number	:

Provider Business Practice Location Address
First Line	:	1514 N KANSAS ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-4233
Country	:	US
Telephone Number	:	915-317-0980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2012
Last Update Date	:	02/13/2012

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Directions to “ ADRIANA PRIETO ” Practice Location

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