Provider Demographics
NPI:1992261598
Name:EWEFADA, ARIEL (CD(DONA), LCCE, CLEC)
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:EWEFADA
Suffix:
Gender:F
Credentials:CD(DONA), LCCE, CLEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6130 7TH ST NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-5041
Mailing Address - Country:US
Mailing Address - Phone:612-807-8363
Mailing Address - Fax:
Practice Address - Street 1:6130 7TH ST NE
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-5041
Practice Address - Country:US
Practice Address - Phone:612-807-8363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN374J00000X
MN12406374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula