Provider Demographics
NPI:1437638368
Name:WHITELEY, ANGELICA (MA)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:
Last Name:WHITELEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10260 DYLAN ST APT 530
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-4817
Mailing Address - Country:US
Mailing Address - Phone:321-412-6672
Mailing Address - Fax:
Practice Address - Street 1:10260 DYLAN ST APT 530
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4817
Practice Address - Country:US
Practice Address - Phone:321-412-6672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health