Provider Demographics
NPI:1013535541
Name:D'ANGELO, PERA-CHANEL MELANIECE
Entity Type:Individual
Prefix:MRS
First Name:PERA-CHANEL
Middle Name:MELANIECE
Last Name:D'ANGELO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:PERA-CHANEL
Other - Middle Name:MELANIECE
Other - Last Name:MCFADDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4016 PINE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-5024
Mailing Address - Country:US
Mailing Address - Phone:561-929-8196
Mailing Address - Fax:
Practice Address - Street 1:3520 OAKS WAY APT 904
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-5387
Practice Address - Country:US
Practice Address - Phone:305-807-1909
Practice Address - Fax:305-397-0308
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst