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General NPI Number Information
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NPI Number | 1649937376
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Entity Type | Individual
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Provider Name | ANGELINA MARIE MCGUIRE
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Gender | Female
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Dates
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Enumeration Date | 11/17/2021
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 208 KIDD DR
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City | BEREA
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State | KY
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Zip | 40403-9593
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Country | US
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Telephone | 859-428-7862
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Fax | 859-999-7869
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Provider Business Mailing Address
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Address Line | PO BOX 802
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City | BEREA
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State | KY
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Zip | 40403-0802
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Country | US
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Telephone | 859-428-7862
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Fax | 859-999-7869
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 21-194084
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License Number State |
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