Healthcare Provider Details

I. General information

NPI: 1760106371
Provider Name (Legal Business Name): ARIEL FELDMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2022
Last Update Date: 09/27/2022
Certification Date: 09/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 CHIPPEWA ST
CLAWSON MI
48017-2037
US

IV. Provider business mailing address

1669 W MAPLE RD
BIRMINGHAM MI
48009-1230
US

V. Phone/Fax

Practice location:
  • Phone: 248-840-1616
  • Fax:
Mailing address:
  • Phone: 248-646-3347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: