Provider Demographics
NPI:1316416704
Name:DISCEPOLI, ANGELA LYNN
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:LYNN
Last Name:DISCEPOLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 ALBERT SABIN WAY
Mailing Address - Street 2:ROOM 406
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2801
Mailing Address - Country:US
Mailing Address - Phone:513-558-5825
Mailing Address - Fax:513-558-8838
Practice Address - Street 1:311 ALBERT SABIN WAY
Practice Address - Street 2:ROOM 406
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2801
Practice Address - Country:US
Practice Address - Phone:513-558-5825
Practice Address - Fax:513-558-8838
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator