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General NPI Number Information
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NPI Number | 1457905820
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Entity Type | Organization
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Legal Business Name | DR. ANGELA SALLIE, PLLC
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Dates
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Enumeration Date | 07/24/2019
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 3551 ROGER BROOKE DR BROOKE ARMY MEDICAL CENTER
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234
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Country | US
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Telephone | 901-456-4487
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Fax |
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Provider Business Mailing Address
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Address Line | 8877 N 107TH AVE STE 302, 499
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City | PEORIA
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State | AZ
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Zip | 85345
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Country | US
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Telephone | 901-456-4487
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. ANGELA TURNER
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Credential | PSY.D.
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Telephone | 901-456-4487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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