Healthcare Provider Details

I. General information

NPI: 1508090580
Provider Name (Legal Business Name): ANGELA P. CUEVAS M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2009
Last Update Date: 05/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S. PROGRESS AVENUE
HARRISBURG PA
17109-4638
US

IV. Provider business mailing address

200 N 7TH STREET
LEBANON PA
17046-5040
US

V. Phone/Fax

Practice location:
  • Phone: 717-526-4889
  • Fax: 717-671-9149
Mailing address:
  • Phone: 717-273-1710
  • Fax: 717-273-1416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: