Provider Demographics
NPI:1447808571
Name:OPPONG, ARIEL
Entity type:Individual
Prefix:MS
First Name:ARIEL
Middle Name:
Last Name:OPPONG
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 1:8436 CREEK HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-8695
Mailing Address - Country:US
Mailing Address - Phone:614-447-4646
Mailing Address - Fax:
Practice Address - Street 1:7400 HUNTINGTON PARK DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-5617
Practice Address - Country:US
Practice Address - Phone:855-792-6446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-02
Last Update Date:2019-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.168721101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)