Healthcare Provider Details

I. General information

NPI: 1366134645
Provider Name (Legal Business Name): MRS. ARIEL BEEVERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9533 M 65 S
LACHINE MI
49753-9492
US

IV. Provider business mailing address

9533 M 65 S
LACHINE MI
49753-9492
US

V. Phone/Fax

Practice location:
  • Phone: 989-278-8174
  • Fax:
Mailing address:
  • Phone: 989-278-8174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: