Provider Demographics
NPI:1265123434
Name:MANCIPE ARROYAVE, ANA
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:MANCIPE ARROYAVE
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 1:401 GOLDEN ISLES DR APT 504
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7578
Mailing Address - Country:US
Mailing Address - Phone:954-861-8291
Mailing Address - Fax:
Practice Address - Street 1:401 GOLDEN ISLES DR APT 504
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-7578
Practice Address - Country:US
Practice Address - Phone:954-861-8291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty