Provider Demographics
NPI:1306655899
Name:APARICIO, REYNA GUADALUPE
Entity type:Individual
Prefix:
First Name:REYNA
Middle Name:GUADALUPE
Last Name:APARICIO
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 1:1875 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-2613
Mailing Address - Country:US
Mailing Address - Phone:952-242-4015
Mailing Address - Fax:
Practice Address - Street 1:1875 PLAZA DR
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2613
Practice Address - Country:US
Practice Address - Phone:952-242-4015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician