Provider Demographics
NPI:1790486793
Name:MKHITARYAN-GOLIGHTLY, ARMINE
Entity Type:Individual
Prefix:
First Name:ARMINE
Middle Name:
Last Name:MKHITARYAN-GOLIGHTLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ARMINE
Other - Middle Name:
Other - Last Name:MKHITARYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:5015 EAGLE ROCK BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-2087
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5015 EAGLE ROCK BLVD STE 208
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-2087
Practice Address - Country:US
Practice Address - Phone:800-371-1121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst