Provider Demographics
NPI:1831716117
Name:AMADO, ARIANNA VELAZQUEZ
Entity type:Individual
Prefix:
First Name:ARIANNA
Middle Name:VELAZQUEZ
Last Name:AMADO
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 1:105 32ND ST SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49548-1135
Mailing Address - Country:US
Mailing Address - Phone:616-690-9756
Mailing Address - Fax:
Practice Address - Street 1:105 32ND ST SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49548-1135
Practice Address - Country:US
Practice Address - Phone:616-690-9756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician