Provider Demographics
NPI:1467855924
Name:PRESTON, AREIGNA MARIE (OMT, LMT, BCTMB)
Entity Type:Individual
Prefix:
First Name:AREIGNA
Middle Name:MARIE
Last Name:PRESTON
Suffix:
Gender:F
Credentials:OMT, LMT, BCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3954 RIVERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1894
Mailing Address - Country:US
Mailing Address - Phone:470-323-6020
Mailing Address - Fax:
Practice Address - Street 1:3954 RIVERSTONE DR
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1894
Practice Address - Country:US
Practice Address - Phone:470-323-6020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20133096225700000X
VA0019011450225700000X
GAMT013230225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV20133096OtherSTATE LICENSE
GA1467855924Medicaid
GAMT013230OtherSTATE LICENSE
VA0019011450OtherSTATE LICENSE