Provider Demographics
NPI:1609584952
Name:FAEZ, ALIANA
Entity Type:Individual
Prefix:
First Name:ALIANA
Middle Name:
Last Name:FAEZ
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 1:3432 OAK TRAIL CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-2755
Mailing Address - Country:US
Mailing Address - Phone:720-921-5694
Mailing Address - Fax:
Practice Address - Street 1:3432 OAK TRAIL CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2755
Practice Address - Country:US
Practice Address - Phone:720-921-5694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician