Provider Demographics
NPI:1497173108
Name:MCCANN, ANGELA (ND, DAOM)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MCCANN
Suffix:
Gender:F
Credentials:ND, DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 NOOSENECK HILL RD
Mailing Address - Street 2:
Mailing Address - City:WEST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02817-1523
Mailing Address - Country:US
Mailing Address - Phone:401-397-6333
Mailing Address - Fax:
Practice Address - Street 1:66 NOOSENECK HILL RD
Practice Address - Street 2:
Practice Address - City:WEST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02817-1523
Practice Address - Country:US
Practice Address - Phone:401-397-6333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT607171100000X
CT516175F00000X
175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist