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NPI Code Detail

MEDICARE: ARELIA SUSTAITA MSW

MEDICARE: ARELIA SUSTAITA MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6851100254MI

General Provider Information

NPI Number : 1417496571
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARELIA SUSTAITA MSW
Provider Business Mailing Address
First Line : 118 E STRATHMORE AVE
Second Line :
City : PONTIAC
State : MI
Zip : 48340-2768
Country : US
Telephone Number : 248-909-4313
Fax Number :
Provider Business Practice Location Address
First Line : 2399 E WALTON BLVD
Second Line :
City : AUBURN HILLS
State : MI
Zip : 48326-1955
Country : US
Telephone Number : 248-475-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2017
Last Update Date : 07/17/2022

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