Healthcare Provider Details

I. General information

NPI: 1235483298
Provider Name (Legal Business Name): ANGE ANGLADE MSW, CHHC, AADP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2012
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4130 HUNT PL NE
WASHINGTON DC
20019-3565
US

IV. Provider business mailing address

4130 HUNT PL NE
WASHINGTON DC
20019-3565
US

V. Phone/Fax

Practice location:
  • Phone: 202-388-4300
  • Fax:
Mailing address:
  • Phone: 202-388-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLG101595
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: