Provider Demographics
NPI:1144099433
Name:REIS DE MORAIS, ARILENE
Entity type:Individual
Prefix:
First Name:ARILENE
Middle Name:
Last Name:REIS DE MORAIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 WALTERSWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21239-2422
Mailing Address - Country:US
Mailing Address - Phone:443-653-7472
Mailing Address - Fax:
Practice Address - Street 1:1909 EMMORTON RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6256
Practice Address - Country:US
Practice Address - Phone:410-803-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA5712225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant