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General NPI Number Information
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NPI Number | 1447572284
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Entity Type | Individual
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Provider Name | DORINDA MARY ANGELO RN, LPC
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Gender | Female
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 02/22/2010
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Provider Practice Location Address
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Address Line | 61 N MAPLE AVE
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-3255
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Country | US
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Telephone | 201-788-3773
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Fax |
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Provider Business Mailing Address
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Address Line | 44 MURRAY AVE
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City | MAHWAH
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State | NJ
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Zip | 07430-3027
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Country | US
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Telephone | 201-891-5163
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00401900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR07181600
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License Number State | NJ
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