Provider Demographics
NPI:1710558515
Name:FRASCELLA ARRIAGA, ANGELA MARIA
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIA
Last Name:FRASCELLA ARRIAGA
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 1:5509 DAMICO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-2254
Mailing Address - Country:US
Mailing Address - Phone:702-286-8370
Mailing Address - Fax:
Practice Address - Street 1:2110 E FLAMINGO RD STE 205
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5192
Practice Address - Country:US
Practice Address - Phone:702-620-5105
Practice Address - Fax:877-220-2664
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician