Provider Demographics
NPI:1033654421
Name:FIELDS, ANGEL
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:FIELDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 W BAYOU ST
Mailing Address - Street 2:
Mailing Address - City:FARMERVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71241-2802
Mailing Address - Country:US
Mailing Address - Phone:318-368-2300
Mailing Address - Fax:318-368-7551
Practice Address - Street 1:102 W BAYOU ST
Practice Address - Street 2:
Practice Address - City:FARMERVILLE
Practice Address - State:LA
Practice Address - Zip Code:71241
Practice Address - Country:US
Practice Address - Phone:318-368-2300
Practice Address - Fax:318-368-7551
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-21
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health