=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831816578
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARANELLA DIONISIO VILLALUZ PT, PTA, MOH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2022
-----------------------------------------------------
Last Update Date | 10/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20960 STARBRICK RD
-----------------------------------------------------
City | EDWARDSBURG
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49112-9211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-676-8646
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20960 STARBRICK RD
-----------------------------------------------------
City | EDWARDSBURG
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49112-9211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-676-8646
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 05015350A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 050965-01
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 225200000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Assistant
-----------------------------------------------------
License Number | 012147-01
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 5501303279
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------