Healthcare Provider Details

I. General information

NPI: 1669520755
Provider Name (Legal Business Name): ANGELA K SEHGAL EDD, ATC, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 SANDELS FLORIDA STATE UNIVERSITY
TALLAHASSEE FL
32306-1493
US

IV. Provider business mailing address

422 SANDELS BUILDING FLORIDA STATE UNIVERSITY
TALLAHASSEE FL
32306-1493
US

V. Phone/Fax

Practice location:
  • Phone: 850-644-1899
  • Fax: 850-645-5000
Mailing address:
  • Phone: 850-644-1899
  • Fax: 850-645-5000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAL 10
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: