Healthcare Provider Details

I. General information

NPI: 1710898937
Provider Name (Legal Business Name): ARIANA LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47737 VAN DYKE AVE
SHELBY TOWNSHIP MI
48317-3372
US

IV. Provider business mailing address

63 MAPLEFIELD RD
PLEASANT RIDGE MI
48069-1020
US

V. Phone/Fax

Practice location:
  • Phone: 586-623-8030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6851122238
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: