Provider Demographics
NPI:1417336124
Name:HANEY, ANGEL (BA)
Entity Type:Individual
Prefix:MISS
First Name:ANGEL
Middle Name:
Last Name:HANEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 GROOM RD
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714-3046
Mailing Address - Country:US
Mailing Address - Phone:225-757-5699
Mailing Address - Fax:
Practice Address - Street 1:4425 GROOM RD
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714-3046
Practice Address - Country:US
Practice Address - Phone:225-757-5699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health