Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1043677768 |
---|---|
Provider Name | Arianna Alexus Carter-Bivens |
First Address | Kalamazoo, MI 49006 |
Second Address | Kalamazoo, MI 49006-5207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2016 |
Last Update Date | 26/01/2016 |