Healthcare Provider Details

I. General information

NPI: 1689277311
Provider Name (Legal Business Name): ANGELA DOWDY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 11/17/2020
Certification Date: 11/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 N CANFIELD NILES RD # 47
YOUNGSTOWN OH
44515-2343
US

IV. Provider business mailing address

45 N CANFIELD NILES RD # 47
YOUNGSTOWN OH
44515-2343
US

V. Phone/Fax

Practice location:
  • Phone: 330-330-8777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: