Provider Demographics
NPI:1407506116
Name:JARVIS, ARIES JEWEL ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:ARIES
Middle Name:JEWEL ELIZABETH
Last Name:JARVIS
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 1:157 AGIN WAY
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:KY
Mailing Address - Zip Code:40045-1510
Mailing Address - Country:US
Mailing Address - Phone:812-599-7564
Mailing Address - Fax:
Practice Address - Street 1:120 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-1295
Practice Address - Country:US
Practice Address - Phone:317-512-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician