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General NPI Number Information
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NPI Number | 1942774500
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Entity Type | Individual
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Provider Name | ANGELA MARIE WEBB PSY.D
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Gender | Female
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Dates
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Enumeration Date | 01/17/2019
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Last Update Date | 05/19/2024
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Provider Practice Location Address
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Address Line | 212 W COLUMBIA ST STE B
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City | FARMINGTON
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State | MO
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Zip | 63640-1700
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Country | US
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Telephone | 573-315-3800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 142
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City | BONNE TERRE
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State | MO
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Zip | 63628-0142
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Country | US
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Telephone | 417-569-0816
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Fax | 573-315-3815
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2015044985
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License Number State | MO
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