Provider Demographics
NPI:1508565250
Name:CRAIG, ANGELA ARDYS (BS)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:ARDYS
Last Name:CRAIG
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 SHAWNEE DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4208
Mailing Address - Country:US
Mailing Address - Phone:540-486-3904
Mailing Address - Fax:
Practice Address - Street 1:3150 SHAWNEE DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4208
Practice Address - Country:US
Practice Address - Phone:540-486-3904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist