Provider Demographics
NPI:1679107569
Name:PRICE, ARADEAN ELLIS
Entity Type:Individual
Prefix:
First Name:ARADEAN
Middle Name:ELLIS
Last Name:PRICE
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 1:1441 BOXWOOD BLVD APT D18
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-2799
Mailing Address - Country:US
Mailing Address - Phone:706-561-5535
Mailing Address - Fax:706-561-8282
Practice Address - Street 1:1441 BOXWOOD BLVD APT D18
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-2799
Practice Address - Country:US
Practice Address - Phone:706-561-5535
Practice Address - Fax:706-561-8282
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator