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General NPI Number Information
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NPI Number | 1396280418
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Entity Type | Organization
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Legal Business Name | KATHERINE W ANGELL LLC
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Dates
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Enumeration Date | 12/28/2016
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Last Update Date | 12/28/2016
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Provider Practice Location Address
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Address Line | 308 RIDGELAND DR
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City | GREENVILLE
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State | SC
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Zip | 29601-3609
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Country | US
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Telephone | 803-467-2401
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Fax |
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Provider Business Mailing Address
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Address Line | 21 SIMMONS AVE
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City | GREENVILLE
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State | SC
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Zip | 29607-2920
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Country | US
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Telephone | 803-467-2401
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MRS. KATHERINE ANGELL
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Credential | LLC
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Telephone | 803-467-2401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6491
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License Number State | SC
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