Basic Information
| Provider Information | |||||||||
| NPI: | 1699233064 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARAOS | ||||||||
| FirstName: | ANGELICA | ||||||||
| MiddleName: | REYES | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LIMITED LICENSE MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5440 KIMBERLY DR | ||||||||
| Address2: | |||||||||
| City: | GRAND BLANC | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484395164 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8105168949 | ||||||||
| FaxNumber: | 8106943518 | ||||||||
| Practice Location | |||||||||
| Address1: | 2399 E WALTON BLVD | ||||||||
| Address2: | |||||||||
| City: | AUBURN HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483261955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2484756300 | ||||||||
| FaxNumber: | 2484756403 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2019 | ||||||||
| LastUpdateDate: | 03/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 6801098488 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.