Provider Demographics
NPI:1346745403
Name:WOLDMAN, ARIEL EDEN HAAS (ATC)
Entity type:Individual
Prefix:MS
First Name:ARIEL
Middle Name:EDEN HAAS
Last Name:WOLDMAN
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19955 ROCKSIDE RD APT 1003
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2051
Mailing Address - Country:US
Mailing Address - Phone:216-385-7671
Mailing Address - Fax:
Practice Address - Street 1:4545 COLLEGE RD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-4228
Practice Address - Country:US
Practice Address - Phone:877-632-6446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer