Provider Demographics
NPI:1669970182
Name:ARISTA OSEJO, ASHLIN MICHELE
Entity type:Individual
Prefix:
First Name:ASHLIN
Middle Name:MICHELE
Last Name:ARISTA OSEJO
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 1:1029 W 64TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6416
Mailing Address - Country:US
Mailing Address - Phone:786-873-8256
Mailing Address - Fax:
Practice Address - Street 1:10322 NW 31ST CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-1163
Practice Address - Country:US
Practice Address - Phone:786-873-8256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-30
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician