Provider Demographics
NPI:1770296352
Name:ARHIN, MATILDA A
Entity type:Individual
Prefix:
First Name:MATILDA
Middle Name:A
Last Name:ARHIN
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 1:2566 WALTER WAY
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7977
Mailing Address - Country:US
Mailing Address - Phone:770-265-4761
Mailing Address - Fax:
Practice Address - Street 1:2566 WALTER WAY
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7977
Practice Address - Country:US
Practice Address - Phone:770-265-4761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide