Healthcare Provider Details

I. General information

NPI: 1346649068
Provider Name (Legal Business Name): ARIELLE MARIAH DEAN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2014
Last Update Date: 08/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 ONTARIO ST SUITE #400
CLEVELAND OH
44113
US

IV. Provider business mailing address

24932-C AURORA RD.
BEDFORD HEIGHTS OH
44146
US

V. Phone/Fax

Practice location:
  • Phone: 210-357-3901
  • Fax: 216-357-3903
Mailing address:
  • Phone: 440-439-9440
  • Fax: 440-439-9447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number.021784
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: