Provider Demographics
NPI:1093358012
Name:VILLA- TREVIZO, ARELY
Entity Type:Individual
Prefix:MS
First Name:ARELY
Middle Name:
Last Name:VILLA- TREVIZO
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 1:1151 LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-7654
Mailing Address - Country:US
Mailing Address - Phone:702-541-0257
Mailing Address - Fax:
Practice Address - Street 1:1151 LEWIS ST
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-7654
Practice Address - Country:US
Practice Address - Phone:702-541-0257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health