Provider Demographics
NPI:1043677768
Name:CARTER-BIVENS, ARIANNA ALEXUS
Entity Type:Individual
Prefix:
First Name:ARIANNA
Middle Name:ALEXUS
Last Name:CARTER-BIVENS
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 1:310 S KENDALL AVE
Mailing Address - Street 2:APT 22
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006
Mailing Address - Country:US
Mailing Address - Phone:616-540-9611
Mailing Address - Fax:
Practice Address - Street 1:310 S KENDALL AVE
Practice Address - Street 2:APT 22
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-5207
Practice Address - Country:US
Practice Address - Phone:616-540-9611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner