Healthcare Provider Details

I. General information

NPI: 1548130511
Provider Name (Legal Business Name): ANGIELANCE LAWUO GBOZEE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 GOLD STAR BLVD FL 2
WORCESTER MA
01606-2738
US

IV. Provider business mailing address

135 GOLD STAR BLVD FL 2
WORCESTER MA
01606-2738
US

V. Phone/Fax

Practice location:
  • Phone: 774-433-5453
  • Fax: 508-849-5618
Mailing address:
  • Phone: 774-433-5453
  • Fax: 508-849-5618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: