Provider Demographics
NPI:1225698632
Name:DILLS, ANGELA DENISE (BA, PSCYHOLOGY)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:DENISE
Last Name:DILLS
Suffix:
Gender:F
Credentials:BA, PSCYHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4911 HAVERWOOD LN APT 3226
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-4442
Mailing Address - Country:US
Mailing Address - Phone:414-366-3177
Mailing Address - Fax:
Practice Address - Street 1:320 WESTWAY PL
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-5245
Practice Address - Country:US
Practice Address - Phone:817-516-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health