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NPI Code Detail

MEDICARE: MS. ANGELA ANN BRUMFIELD SUDP

MEDICARE: MS. ANGELA ANN BRUMFIELD SUDP
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCP00000553WA

General Provider Information

NPI Number : 1457065054
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANGELA ANN BRUMFIELD SUDP
Provider Business Mailing Address
First Line : 511 W HERON ST
Second Line :
City : ABERDEEN
State : WA
Zip : 98520-6022
Country : US
Telephone Number : 564-544-1943
Fax Number : 564-544-1928
Provider Business Practice Location Address
First Line : 511 W HERON ST
Second Line :
City : ABERDEEN
State : WA
Zip : 98520-6022
Country : US
Telephone Number : 564-544-1943
Fax Number : 564-544-1928
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2023
Last Update Date : 01/09/2023

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