Provider Demographics
NPI:1366824492
Name:D'ANGELO, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:D'ANGELO
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 1:60 WESTWOOD PL
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-4224
Mailing Address - Country:US
Mailing Address - Phone:828-242-9914
Mailing Address - Fax:
Practice Address - Street 1:60 WESTWOOD PL
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806
Practice Address - Country:US
Practice Address - Phone:828-242-9914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10924101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional