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General NPI Number Information
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NPI Number | 1699260547
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Entity Type | Individual
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Provider Name | ANGELA BRIANA DILWORTH
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Gender | Female
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Dates
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Enumeration Date | 06/23/2018
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Last Update Date | 06/14/2022
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Provider Practice Location Address
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Address Line | 1401 S FEDERAL HWY
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2619
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Country | US
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Telephone | 954-728-8080
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Fax |
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Provider Business Mailing Address
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Address Line | 9447 NW 42ND ST
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City | SUNRISE
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State | FL
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Zip | 33351-7699
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Country | US
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Telephone | 954-610-2507
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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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 | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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