Basic Information
| Provider Information | |||||||||
| NPI: | 1295390862 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARREOLA | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | LUISA | ||||||||
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| Mailing Information | |||||||||
| Address1: | MEDICAL CENTER BLVD | ||||||||
| Address2: | |||||||||
| City: | WINSTON SALEM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 271570001 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1208 EASTCHESTER DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272653165 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368022205 | ||||||||
| FaxNumber: | 3368022206 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2019 | ||||||||
| LastUpdateDate: | 10/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 61135 | TX | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | C012977 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.