Provider Demographics
NPI:1669921151
Name:ARIAS-REYNOSO, MARLENE (DNP, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:
Last Name:ARIAS-REYNOSO
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HQ MEDDACB
Mailing Address - Street 2:UNIT 28037 BLD 700
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09112
Mailing Address - Country:US
Mailing Address - Phone:314-590-2368
Mailing Address - Fax:
Practice Address - Street 1:6184 RIVER PARK PL
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79932-4112
Practice Address - Country:US
Practice Address - Phone:787-564-2542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-26
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136061363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health