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NPI Code Detail

MEDICARE: ARIEL LAABS RBT

MEDICARE: ARIEL LAABS RBT
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1902365380
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARIEL LAABS RBT
Provider Business Mailing Address
First Line : 2804 E 26TH ST STE 1
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57103-4019
Country : US
Telephone Number : 605-271-2690
Fax Number : 605-271-3956
Provider Business Practice Location Address
First Line : 3721 23RD ST S # 201
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56301-6198
Country : US
Telephone Number : 605-271-2690
Fax Number : 605-271-3956
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2019
Last Update Date : 10/15/2019

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