Provider Demographics
NPI:1033858147
Name:FERNANDEZ, ARIEL NICOLE
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:NICOLE
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4475 WILSON RD APT 7304
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-5208
Mailing Address - Country:US
Mailing Address - Phone:832-373-4322
Mailing Address - Fax:
Practice Address - Street 1:18401 TIMBER FOREST DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-2535
Practice Address - Country:US
Practice Address - Phone:281-852-0501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician