Provider Demographics
NPI:1700882206
Name:MIDEI, ARRIN M (SLP)
Entity Type:Individual
Prefix:MRS
First Name:ARRIN
Middle Name:M
Last Name:MIDEI
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:ARRIN
Other - Middle Name:M
Other - Last Name:NIEDENTHAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:108 WOODROW AVE
Mailing Address - Street 2:
Mailing Address - City:ST. CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950
Mailing Address - Country:US
Mailing Address - Phone:740-695-0884
Mailing Address - Fax:
Practice Address - Street 1:108 WOODROW AVE
Practice Address - Street 2:
Practice Address - City:ST. CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950
Practice Address - Country:US
Practice Address - Phone:740-695-0884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.8116235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810001334Medicaid