Provider Demographics
NPI:1346695269
Name:GEISSE, ARIANA
Entity Type:Individual
Prefix:
First Name:ARIANA
Middle Name:
Last Name:GEISSE
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 1:22 MEADOW LN
Mailing Address - Street 2:APARTMENT 9
Mailing Address - City:BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02324-8122
Mailing Address - Country:US
Mailing Address - Phone:951-813-8219
Mailing Address - Fax:
Practice Address - Street 1:22 MEADOW LN
Practice Address - Street 2:APARTMENT 9
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-8122
Practice Address - Country:US
Practice Address - Phone:951-813-8219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service