Doctor Name: | DR. MARY ASHLEY ANGELO |
NPI Number: | 1205104163 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | LPC-3953 |
Business Practice Address: | 4371 E 72nd Ave Commerce City, CO - 800221471 |
Business Phone Number: | 3038533500 |
Business Fax Number: | |
Mailing Address: | 640 S Dahlia Cir, Apt. P108 GLENDALE |
State: | CO |
Postal Code: | 802461357 |
Phone Number: | 3037202674 |
Fax Number: | |
NPI Enumeration Date: | 12/07/2011 |
NPI Last Update Date: | 12/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LPC-3953 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |