Provider Demographics
NPI:1346611944
Name:NEIL, ANGELA DOROTHY
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:DOROTHY
Last Name:NEIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:DOROTHY
Other - Last Name:PECHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:90 NORHT 161 WEST
Mailing Address - Street 2:
Mailing Address - City:EPHRAIM
Mailing Address - State:UT
Mailing Address - Zip Code:84627-1224
Mailing Address - Country:US
Mailing Address - Phone:435-283-9934
Mailing Address - Fax:435-283-9935
Practice Address - Street 1:90 N 161 W
Practice Address - Street 2:
Practice Address - City:EPHRAIM
Practice Address - State:UT
Practice Address - Zip Code:84627-5542
Practice Address - Country:US
Practice Address - Phone:435-283-9934
Practice Address - Fax:435-283-9935
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor