Provider Demographics
NPI:1811469190
Name:SIEGEL, ARIELLA NICOLE (MED, BCBA, COBA)
Entity type:Individual
Prefix:
First Name:ARIELLA
Middle Name:NICOLE
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:MED, BCBA, COBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 MADISON PARK AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-1160
Mailing Address - Country:US
Mailing Address - Phone:631-553-0372
Mailing Address - Fax:
Practice Address - Street 1:6900 HOUSTON RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4884
Practice Address - Country:US
Practice Address - Phone:859-869-0660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-26
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-18-30775103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst