Healthcare Provider Details

I. General information

NPI: 1013992551
Provider Name (Legal Business Name): ANGELA HATFIELD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGELA KLINGENSMITH DDS

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 10/09/2022
Certification Date: 10/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

547 SPINNING RD
DAYTON OH
45431-2157
US

IV. Provider business mailing address

1221 LANGSTON DR
COLUMBUS OH
43220-3929
US

V. Phone/Fax

Practice location:
  • Phone: 937-252-1463
  • Fax:
Mailing address:
  • Phone: 614-570-2529
  • Fax: 614-451-0312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.1901788
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number21041
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: