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General NPI Number Information
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NPI Number | 1356963581
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Entity Type | Organization
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Legal Business Name | ANGELA GREENE, LLC
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Dates
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Enumeration Date | 05/11/2020
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Last Update Date | 05/11/2020
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Provider Practice Location Address
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Address Line | 622 POND VIEW CT
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City | WESTMINSTER
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State | MD
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Zip | 21158-4429
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Country | US
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Telephone | 410-861-7471
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Fax | 410-871-0099
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Provider Business Mailing Address
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Address Line | 622 POND VIEW CT
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City | WESTMINSTER
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State | MD
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Zip | 21158-4429
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Country | US
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Telephone | 410-861-7471
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Fax | 410-871-0099
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA GREENE
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Credential | LCPC
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Telephone | 410-861-7471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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