Provider Demographics
NPI:1508910530
Name:KREBS, ANGELA KATHLEEN (MA, LAMFT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:KATHLEEN
Last Name:KREBS
Suffix:
Gender:F
Credentials:MA, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20936 IXONIA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-7752
Mailing Address - Country:US
Mailing Address - Phone:952-985-5202
Mailing Address - Fax:
Practice Address - Street 1:2414 PARK AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3713
Practice Address - Country:US
Practice Address - Phone:612-879-5320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1401101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health