Provider Demographics
NPI:1922990886
Name:MENDOZA, ARACELY
Entity type:Individual
Prefix:
First Name:ARACELY
Middle Name:
Last Name:MENDOZA
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 1:1109 GREEN MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:ANTHONY
Mailing Address - State:NM
Mailing Address - Zip Code:88021-8605
Mailing Address - Country:US
Mailing Address - Phone:915-218-7634
Mailing Address - Fax:
Practice Address - Street 1:1109 GREEN MEADOWS RD
Practice Address - Street 2:
Practice Address - City:ANTHONY
Practice Address - State:NM
Practice Address - Zip Code:88021-8605
Practice Address - Country:US
Practice Address - Phone:915-218-7634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician