Provider Demographics
NPI:1235803909
Name:MORIARTY, ANGELA M (CPSS)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:MORIARTY
Suffix:
Gender:F
Credentials:CPSS
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:M
Other - Last Name:MORIARTY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPSS
Mailing Address - Street 1:2240 LANDON CT
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-2414
Mailing Address - Country:US
Mailing Address - Phone:402-346-0902
Mailing Address - Fax:402-342-5290
Practice Address - Street 1:2240 LANDON CT
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-2414
Practice Address - Country:US
Practice Address - Phone:402-346-0902
Practice Address - Fax:402-342-5290
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NECPSS-80175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist