Provider Demographics
NPI:1336602127
Name:ARRIOJA, SAMANTHA NICHOLE (RBT)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:NICHOLE
Last Name:ARRIOJA
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5050 9TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-2838
Mailing Address - Country:US
Mailing Address - Phone:305-393-0179
Mailing Address - Fax:
Practice Address - Street 1:5050 9TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-2838
Practice Address - Country:US
Practice Address - Phone:305-393-0179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL104100000X
FLRBT-18-63271106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT-18-63271OtherBACB
FLRBT-18-63271OtherBACB