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General NPI Number Information
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NPI Number | 1750700035
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Entity Type | Individual
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Provider Name | MRS. ANGILIA EGBOSIMBAH
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Gender | Female
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 1916 N LEG RD
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City | AUGUSTA
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State | GA
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Zip | 30909-4402
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Country | US
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Telephone | 706-667-4279
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Fax | 706-667-4278
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Provider Business Mailing Address
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Address Line | 473 OLD EVANS RD APT 109
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City | MARTINEZ
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State | GA
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Zip | 30907-4324
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Country | US
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Telephone | 706-750-4431
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Fax | 706-750-4432
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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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 | 101Y00000X
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Taxonomy Name | Counselor
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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 | 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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