Provider Demographics
NPI:1457012890
Name:CAMARATA, ANGELA LYNN
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:LYNN
Last Name:CAMARATA
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 1:1642 GARNERS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-4413
Mailing Address - Country:US
Mailing Address - Phone:740-407-1573
Mailing Address - Fax:
Practice Address - Street 1:1325 W MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3786
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician