Provider Demographics
NPI:1225898216
Name:ARGUETA-CONTRERAS, MARK BRYAN
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:BRYAN
Last Name:ARGUETA-CONTRERAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9405 LANAE LN
Mailing Address - Street 2:
Mailing Address - City:MANASSAS PARK
Mailing Address - State:VA
Mailing Address - Zip Code:20111-8243
Mailing Address - Country:US
Mailing Address - Phone:571-645-2116
Mailing Address - Fax:
Practice Address - Street 1:9405 LANAE LN
Practice Address - Street 2:
Practice Address - City:MANASSAS PARK
Practice Address - State:VA
Practice Address - Zip Code:20111-8243
Practice Address - Country:US
Practice Address - Phone:571-645-2116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool