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General NPI Number Information
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NPI Number | 1053826545
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Entity Type | Individual
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Provider Name | ANGELA COYLE SCHOOL PSYCHOLOGIST
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Gender | Female
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Dates
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Enumeration Date | 12/06/2017
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Last Update Date | 09/26/2018
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Provider Practice Location Address
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Address Line | 4841 W LONE DOVE DR
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City | MARANA
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State | AZ
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Zip | 85658-4735
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Country | US
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Telephone | 317-947-8280
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Fax |
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Provider Business Mailing Address
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Address Line | 4841 W LONE DOVE DR
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City | MARANA
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State | AZ
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Zip | 85658-4735
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Country | US
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Telephone | 317-947-8280
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 1391338
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 5077742
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License Number State | AZ
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