MEDICARE: ANGIE L TODD LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	5345G	AL

General Provider Information

NPI Number	:	1174196000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGIE L TODD LMSW

Provider Business Mailing Address
First Line	:	5064 VERNON ST
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-3915
Country	:	US
Telephone Number	:	205-410-1523
Fax Number	:

Provider Business Practice Location Address
First Line	:	1728 5TH AVE N
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35203-2023
Country	:	US
Telephone Number	:	205-410-1523
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2021
Last Update Date	:	07/19/2021

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