Provider Demographics
NPI:1184864753
Name:DUGAN, ANGELA EMERICK (PSYD LP)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:EMERICK
Last Name:DUGAN
Suffix:
Gender:F
Credentials:PSYD LP
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:NICOLE
Other - Last Name:EMERICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1400 MADISON AVE
Mailing Address - Street 2:SUITE 628
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-5473
Mailing Address - Country:US
Mailing Address - Phone:507-779-7366
Mailing Address - Fax:507-779-7367
Practice Address - Street 1:1400 MADISON AVE
Practice Address - Street 2:SUITE 628
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-5473
Practice Address - Country:US
Practice Address - Phone:507-779-7366
Practice Address - Fax:507-779-7367
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4997103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical