Provider Demographics
NPI:1205432630
Name:VILLNERVE, ARIA CHRISTINE
Entity type:Individual
Prefix:
First Name:ARIA
Middle Name:CHRISTINE
Last Name:VILLNERVE
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:PO BOX 693
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-0693
Mailing Address - Country:US
Mailing Address - Phone:907-795-3392
Mailing Address - Fax:
Practice Address - Street 1:540 W INTERNATIONAL AIRPORT RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-1105
Practice Address - Country:US
Practice Address - Phone:907-561-5335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician