Provider Demographics
NPI:1962866368
Name:AARON, ANGELA (PHD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:AARON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1303
Mailing Address - Street 2:
Mailing Address - City:RUSSELL SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:42642-1303
Mailing Address - Country:US
Mailing Address - Phone:859-493-1593
Mailing Address - Fax:463-218-9161
Practice Address - Street 1:628 MAIN STREET
Practice Address - Street 2:SUITE A
Practice Address - City:RUSSELL SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:42642
Practice Address - Country:US
Practice Address - Phone:859-797-0221
Practice Address - Fax:463-218-9161
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY172872103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling