Healthcare Provider Details

I. General information

NPI: 1174255418
Provider Name (Legal Business Name): ARIELLE HARRIS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 1ST ST
EMMETSBURG IA
50536-2516
US

IV. Provider business mailing address

306 N MAPLE AVE
GRAETTINGER IA
51342-1027
US

V. Phone/Fax

Practice location:
  • Phone: 712-852-5500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: