Provider Demographics
NPI:1528727674
Name:TAPIA, MARIAH LYNN
Entity type:Individual
Prefix:MISS
First Name:MARIAH
Middle Name:LYNN
Last Name:TAPIA
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 1:1973 RASPBERRY DR NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-8018
Mailing Address - Country:US
Mailing Address - Phone:505-459-1708
Mailing Address - Fax:
Practice Address - Street 1:1973 RASPBERRY DR NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-8018
Practice Address - Country:US
Practice Address - Phone:505-459-1708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician