Healthcare Provider Details

I. General information

NPI: 1962866368
Provider Name (Legal Business Name): ANGELA AARON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2016
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 BROOKFOREST DR
WINSTON SALEM NC
27107-9209
US

IV. Provider business mailing address

267 BROOKFOREST DR
WINSTON SALEM NC
27107-9209
US

V. Phone/Fax

Practice location:
  • Phone: 270-585-8480
  • Fax: 463-218-9161
Mailing address:
  • Phone: 270-585-8480
  • Fax: 463-218-9161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number172872
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: