Provider Demographics
NPI:1740730696
Name:WITTGENSTEIN, ARIANA (PSYD)
Entity type:Individual
Prefix:DR
First Name:ARIANA
Middle Name:
Last Name:WITTGENSTEIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 4TH ST N STE 322
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4313
Mailing Address - Country:US
Mailing Address - Phone:727-469-3344
Mailing Address - Fax:
Practice Address - Street 1:7901 4TH ST N STE 322
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4313
Practice Address - Country:US
Practice Address - Phone:727-469-3344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-04
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9646103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical