Provider Demographics
NPI:1174603690
Name:BUTLER, ANGELA MARETT (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:MARETT
Last Name:BUTLER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:CHRISTINE
Other - Last Name:MARETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1509 STONE HOUSE CT
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601
Mailing Address - Country:US
Mailing Address - Phone:540-542-1150
Mailing Address - Fax:
Practice Address - Street 1:801 S LOUDOUN ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601
Practice Address - Country:US
Practice Address - Phone:540-667-5431
Practice Address - Fax:540-667-2655
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003713103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical