Provider Demographics
NPI:1386146744
Name:JEWELL, AARYN LEIGH
Entity type:Individual
Prefix:
First Name:AARYN
Middle Name:LEIGH
Last Name:JEWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7581 TREVOR CT
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-7030
Mailing Address - Country:US
Mailing Address - Phone:269-903-9931
Mailing Address - Fax:
Practice Address - Street 1:3301 RIDGECREST DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-5860
Practice Address - Country:US
Practice Address - Phone:989-839-2290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician