Provider Demographics
NPI:1699233064
Name:ARAOS, ANGELICA REYES (LIMITED LICENSE MSW)
Entity type:Individual
Prefix:MRS
First Name:ANGELICA
Middle Name:REYES
Last Name:ARAOS
Suffix:
Gender:F
Credentials:LIMITED LICENSE MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5440 KIMBERLY DR
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-5164
Mailing Address - Country:US
Mailing Address - Phone:810-516-8949
Mailing Address - Fax:810-694-3518
Practice Address - Street 1:2399 E WALTON BLVD
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-1955
Practice Address - Country:US
Practice Address - Phone:248-475-6300
Practice Address - Fax:248-475-6403
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010984881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical