Provider Demographics
NPI:1275098485
Name:HEPWORTH, ANGELA R (MS)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:R
Last Name:HEPWORTH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 72772
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-1030
Mailing Address - Country:US
Mailing Address - Phone:480-999-5666
Mailing Address - Fax:
Practice Address - Street 1:7010 E ACOMA DR STE 101H
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-3550
Practice Address - Country:US
Practice Address - Phone:480-999-5666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-01
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBEH-000414103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst