Provider Demographics
NPI:1740699545
Name:WILDEN, ARIANNE MARLENE (MA CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:ARIANNE
Middle Name:MARLENE
Last Name:WILDEN
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8518 CARRIAGE HILL DR NE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-1622
Mailing Address - Country:US
Mailing Address - Phone:330-207-5504
Mailing Address - Fax:
Practice Address - Street 1:2565 NILES VIENNA RD
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4401
Practice Address - Country:US
Practice Address - Phone:330-652-2053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-8301235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist