Provider Demographics
NPI:1386111276
Name:FLYNN, ARIELLE JOY (MS, LCGC)
Entity type:Individual
Prefix:MRS
First Name:ARIELLE
Middle Name:JOY
Last Name:FLYNN
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:MS
Other - First Name:ARIELLE
Other - Middle Name:JOY
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:414 N SEVENTH STREET
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501
Mailing Address - Country:US
Mailing Address - Phone:701-323-8854
Mailing Address - Fax:
Practice Address - Street 1:414 N SEVENTH STREET
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501
Practice Address - Country:US
Practice Address - Phone:701-323-8854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND123170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS