Healthcare Provider Details

I. General information

NPI: 1740292523
Provider Name (Legal Business Name): ANGELA D PERKINS PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGELA D WATSON PSYD

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 16TH ST NE STE 201
CEDAR RAPIDS IA
52402-4665
US

IV. Provider business mailing address

700 16TH STREET NE STE 201
CEDAR RAPIDS IA
52402-4665
US

V. Phone/Fax

Practice location:
  • Phone: 319-363-3935
  • Fax: 319-363-3448
Mailing address:
  • Phone: 319-363-3935
  • Fax: 319-363-3448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number00995
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number00995
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: