Provider Demographics
NPI:1346910304
Name:LEWIS, ARIELLE ELISE
Entity Type:Individual
Prefix:
First Name:ARIELLE
Middle Name:ELISE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ARIELLE
Other - Middle Name:ELISE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:859 FORTUNEGATE DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-3521
Mailing Address - Country:US
Mailing Address - Phone:614-964-1671
Mailing Address - Fax:
Practice Address - Street 1:859 FORTUNEGATE DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-3521
Practice Address - Country:US
Practice Address - Phone:614-964-1671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst