Provider Demographics
NPI:1417647470
Name:STINNETT, ANGEL M
Entity Type:Individual
Prefix:MS
First Name:ANGEL
Middle Name:M
Last Name:STINNETT
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 1:6411 ASHBOROUGH CT APT C
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-3361
Mailing Address - Country:US
Mailing Address - Phone:850-530-3704
Mailing Address - Fax:
Practice Address - Street 1:6411 ASHBOROUGH CT APT C
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-3361
Practice Address - Country:US
Practice Address - Phone:850-530-3704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist