Provider Demographics
NPI:1043061781
Name:DALE, ARIEL KIRSTEN
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:KIRSTEN
Last Name:DALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 E PETTIGREW ST APT 446
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-3887
Mailing Address - Country:US
Mailing Address - Phone:310-956-5037
Mailing Address - Fax:
Practice Address - Street 1:1513 WALNUT ST STE 125
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5900
Practice Address - Country:US
Practice Address - Phone:310-956-5037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10647A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist