Provider Demographics
NPI:1073775037
Name:MURRAY, ANGELA A (MA)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:A
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9929 E 126TH ST
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-9404
Mailing Address - Country:US
Mailing Address - Phone:317-436-8961
Mailing Address - Fax:317-436-8966
Practice Address - Street 1:53633 COUNTY ROAD 7
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-5130
Practice Address - Country:US
Practice Address - Phone:574-343-2001
Practice Address - Fax:574-343-2156
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-12-11425103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst