Provider Demographics
NPI:1346350485
Name:ANGLADE, ESTHER TAYLOR (LMFT)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:TAYLOR
Last Name:ANGLADE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 W. GOVERNMENT STREET, SUITE 207
Mailing Address - Street 2:BROOKS OF WATER COUNSELING
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:30942
Mailing Address - Country:US
Mailing Address - Phone:601-706-4021
Mailing Address - Fax:
Practice Address - Street 1:1700 W. GOVERNMENT STREET, SUITE 207
Practice Address - Street 2:BROOKS OF WATER COUNSELING
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042
Practice Address - Country:US
Practice Address - Phone:601-706-4021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST0378106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist