Provider Demographics
NPI:1013216993
Name:SOPER, MARIA ANGELA D (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIA ANGELA
Middle Name:D
Last Name:SOPER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:D
Other - Last Name:SOPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:14230 ASHLAND LANDING DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-8188
Mailing Address - Country:US
Mailing Address - Phone:281-746-4142
Mailing Address - Fax:
Practice Address - Street 1:25511 BUDDE RD
Practice Address - Street 2:SUITE 1502
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2080
Practice Address - Country:US
Practice Address - Phone:281-746-4142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18106104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker