Healthcare Provider Details

I. General information

NPI: 1801712070
Provider Name (Legal Business Name): ANGELICA ANN ALLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CALDWELL RD
AUGUSTA ME
04330-5735
US

IV. Provider business mailing address

10 CALDWELL RD
AUGUSTA ME
04330-5735
US

V. Phone/Fax

Practice location:
  • Phone: 207-626-3448
  • Fax:
Mailing address:
  • Phone: 207-626-3448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMC26033
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: