Provider Demographics
NPI:1295814358
Name:WITMAN, ANGIE (LMFT, LMLP)
Entity Type:Individual
Prefix:
First Name:ANGIE
Middle Name:
Last Name:WITMAN
Suffix:
Gender:F
Credentials:LMFT, LMLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2099 N COLLINS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2698
Mailing Address - Country:US
Mailing Address - Phone:972-437-4698
Mailing Address - Fax:972-671-2087
Practice Address - Street 1:100 E COLLEGE DR
Practice Address - Street 2:
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701-3702
Practice Address - Country:US
Practice Address - Phone:800-204-7593
Practice Address - Fax:785-899-6303
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0335101YP2500X
KS358106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist