MEDICARE: ARIANNA HAVIV

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000	OTHER		N/A

General Provider Information

NPI Number	:	1851896351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIANNA HAVIV

Provider Business Mailing Address
First Line	:	2440 E TAHQUITZ CANYON WAY APT 110
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-7019
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2440 E TAHQUITZ CANYON WAY APT 110
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-7019
Country	:	US
Telephone Number	:	760-409-7291
Fax Number	:

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

Provider Enumeration Date	:	03/27/2018
Last Update Date	:	03/27/2018

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