Provider Demographics
NPI:1346429446
Name:COX, ANGELA RAE (LCSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:RAE
Last Name:COX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 SWEETBRIAR WAY
Mailing Address - Street 2:
Mailing Address - City:CENTERTON
Mailing Address - State:AR
Mailing Address - Zip Code:72719-5013
Mailing Address - Country:US
Mailing Address - Phone:479-426-7353
Mailing Address - Fax:
Practice Address - Street 1:1441 SWEETBRIAR WAY
Practice Address - Street 2:
Practice Address - City:CENTERTON
Practice Address - State:AR
Practice Address - Zip Code:72719-5013
Practice Address - Country:US
Practice Address - Phone:479-426-7353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker