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General NPI Number Information
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NPI Number | 1669018859
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Entity Type | Individual
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Provider Name | ANGELA CARROLL CHILDS BS, RPSGT, RST, CCSH
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Gender | Female
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Dates
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Enumeration Date | 11/21/2019
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Last Update Date | 11/21/2019
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Provider Practice Location Address
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Address Line | 5050 POPLAR AVE STE 300
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City | MEMPHIS
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State | TN
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Zip | 38157-0300
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Country | US
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Telephone | 901-820-3444
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Fax | 901-937-3345
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Provider Business Mailing Address
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Address Line | 2215 ORR RD
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City | ARLINGTON
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State | TN
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Zip | 38002-4332
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Country | US
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Telephone | 901-867-7001
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Fax | 901-867-1918
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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 | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number | 433
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License Number State | TN
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