Provider Demographics
NPI:1073270658
Name:PITTENGER, ARIANNA MICHELE
Entity Type:Individual
Prefix:
First Name:ARIANNA
Middle Name:MICHELE
Last Name:PITTENGER
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 1:16970 CHANDLER RD APT 4101A
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6238
Mailing Address - Country:US
Mailing Address - Phone:810-955-0703
Mailing Address - Fax:
Practice Address - Street 1:5093 E BROOKFIELD DR
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-4772
Practice Address - Country:US
Practice Address - Phone:989-640-7610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851117098101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health