Healthcare Provider Details

I. General information

NPI: 1417491531
Provider Name (Legal Business Name): ARNISHA R GAINER RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2016
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 E 22ND ST
CLEVELAND OH
44115-3204
US

IV. Provider business mailing address

4440 E PIKES PEAK AVE APT 325
COLORADO SPRINGS CO
80916-5230
US

V. Phone/Fax

Practice location:
  • Phone: 216-931-1400
  • Fax:
Mailing address:
  • Phone: 719-465-3695
  • Fax: 719-465-3914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.1201424
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB505750
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: