Provider Demographics
NPI:1972311751
Name:EDWARDS, ARIANNA CAMILLE
Entity type:Individual
Prefix:
First Name:ARIANNA
Middle Name:CAMILLE
Last Name:EDWARDS
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:PO BOX 684
Mailing Address - Street 2:
Mailing Address - City:WALLKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12589-0684
Mailing Address - Country:US
Mailing Address - Phone:779-875-3603
Mailing Address - Fax:
Practice Address - Street 1:12 MAIN ST UNIT 1
Practice Address - Street 2:
Practice Address - City:WALDEN
Practice Address - State:NY
Practice Address - Zip Code:12586-1823
Practice Address - Country:US
Practice Address - Phone:779-875-3603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-24
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter