Healthcare Provider Details

I. General information

NPI: 1679993422
Provider Name (Legal Business Name): ANGELA BETH HESS BCBA-D, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2014
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6504 MOUNTAINDALE RD
THURMONT MD
21788-2719
US

IV. Provider business mailing address

6504 MOUNTAINDALE RD
THURMONT MD
21788-2719
US

V. Phone/Fax

Practice location:
  • Phone: 443-243-7647
  • Fax:
Mailing address:
  • Phone: 301-524-8203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: